Risk Factors for Moderate and Severe Persistent Pain in Patients Undergoing Total Knee and Hip Arthroplasty: A Prospective Predictive StudyReport as inadecuate




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Persistent post-surgical pain PPSP is a major clinical problem with significant individual, social and health care costs. The aim of this study was to examine the joint role of demographic, clinical and psychological risk factors in the development of moderate and severe PPSP after Total Knee and Hip Arthroplasty TKA and THA, respectively. This was a prospective study wherein a consecutive sample of 92 patients were assessed 24 hours before T1, 48 hours after T2 and 4–6 months T3 after surgery. Hierarchical logistic regression analyses were performed to identify predictors of moderate and severe levels of PPSP. Four to six months after TKA and THA, 54 patients 58.7% reported none or mild pain Numerical Rating Scale: NRS ≤3, whereas 38 41.3% reported moderate to severe pain NRS >3. In the final multivariate hierarchical logistic regression analyses, illness representations concerning the condition leading to surgery osteoarthritis, such as a chronic timeline perception of the disease, emerged as a significant predictor of PPSP. Additionally, post-surgical anxiety also showed a predictive role in the development of PPSP. Pre-surgical pain was the most significant clinical predictive factor and, as expected, undergoing TKA was associated with greater odds of PPSP development than THA. The findings on PPSP predictors after major joint arthroplasties can guide clinical practice in terms of considering cognitive and emotional factors, together with clinical factors, in planning acute pain management before and after surgery.



Author: Patrícia R. Pinto, Teresa McIntyre, Ramón Ferrero, Armando Almeida, Vera Araújo-Soares

Source: http://plos.srce.hr/



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