Predictors of Chronic Postsurgical Pain in Elderly Patients Undergoing Hip Arthroplasty: A Multi-Center Retrospective Cohort Study
Yi Lu,1,* Bang Hu,2,* Haitao Dai,3,* Bao Wang,1 Jiayin Yao,4 Xinhua Yao1 1Department of Anesthesiology, The Affiliated TCM Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, People’s Republic of China; 2Department of Colorectal Surgery, Guangdong Provincial Key Labora...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2021-11-01
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| Series: | International Journal of General Medicine |
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| Online Access: | https://www.dovepress.com/predictors-of-chronic-postsurgical-pain-in-elderly-patients-undergoing-peer-reviewed-fulltext-article-IJGM |
| _version_ | 1828147343506014208 |
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| author | Lu Y Hu B Dai H Wang B Yao J Yao X |
| author_facet | Lu Y Hu B Dai H Wang B Yao J Yao X |
| author_sort | Lu Y |
| collection | DOAJ |
| description | Yi Lu,1,* Bang Hu,2,* Haitao Dai,3,* Bao Wang,1 Jiayin Yao,4 Xinhua Yao1 1Department of Anesthesiology, The Affiliated TCM Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, People’s Republic of China; 2Department of Colorectal Surgery, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, People’s Republic of China; 3Department of Interventional Radiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, People’s Republic of China; 4Department of Gastroenterology, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xinhua YaoDepartment of Anesthesiology, The Affiliated TCM Hospital of Guangzhou Medical University, 16th Zhuji Road, Guangzhou, Guangdong Province, 510130, People’s Republic of ChinaTel +86 13719289709Email yxh200210@126.comJiayin YaoDepartment of Gastroenterology, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, The Sixth Affiliated Hospital of Sun Yat-Sen University, 26th Yuancun Second Road, Guangzhou, Guangdong Province, 510655, People’s Republic of ChinaTel +86 13826462890Email yjyin@mail3.sysu.edu.cnBackground: Identifying patients at high risk of developing chronic postsurgical pain (CPSP) is of extreme importance in order to help launch appropriate therapeutic strategies and intensive initiation of pain management.Aim: In this study, we aimed to conduct a multi-center retrospective cohort study to establish a prognostic model and a nomogram to predict the risks of CPSP in elderly patients who underwent hip arthroplasty at 6 months postoperatively.Methods: We collected data from 736 patients aged > 65 years who had undergone hip arthroplasty from October 1, 2016 to September, 30, 2018 at multiple tertiary referral centers in Guangzhou, China. All data were randomly stratified into a training set and a testing set at a ratio of 8:2. Data were analyzed via multiple logistic regression analysis with receiver operating characteristic (ROC) curves and areas under the curve. This model was further validated by estimating calibration and discrimination. A nomogram was ultimately developed.Results: A total of 736 eligible patients were enrolled, 27.20% of whom developed CPSP within 6 months postoperatively. Preoperative pain in the surgical area (OR=2.456, 95% CI:1.814– 3.327, P< 0.001), preoperative depression state (OR=1.256, 95% CI:1.146– 1.378, P< 0.001), surgical type (OR=7.138, 95% CI:3.548– 14.364, P< 0.001), acute postoperative numerical rating scale score (OR=5.537, 95% CI:3.607– 8.499, P< 0.001) and analgesic type (patient-controlled epidural analgesia: OR=0.129, 95% CI:0.055– 0.299, P< 0.001; patient-controlled intravenous analgesia: OR=0.033, 95% CI:0.011– 0.097, P< 0.001) were identified as independent significant factors associated with CPSP. A prognostic model was established and further validated. An ROC curve confirmed the predictive ability of this model with a high sensitivity value of 92.12% (95% CI:86.90– 95.74) and specificity value of 91.72% (95% CI:88.77– 94.11). A nomogram was developed to simplify the use of the predictive model in clinical practice.Conclusion: This prognostic model could be of great value in clinical practice, serving as the basis for early personalized analgesic management of elderly patients undergoing hip arthroplasty.Keywords: chronic postsurgical pain, CPSP, prognostic model, nomogram, retrospective study |
| first_indexed | 2024-04-11T20:59:33Z |
| format | Article |
| id | doaj.art-ceb57a729cf84b3a94fba4fc88662aa9 |
| institution | Directory Open Access Journal |
| issn | 1178-7074 |
| language | English |
| last_indexed | 2024-04-11T20:59:33Z |
| publishDate | 2021-11-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | International Journal of General Medicine |
| spelling | doaj.art-ceb57a729cf84b3a94fba4fc88662aa92022-12-22T04:03:34ZengDove Medical PressInternational Journal of General Medicine1178-70742021-11-01Volume 147885789470470Predictors of Chronic Postsurgical Pain in Elderly Patients Undergoing Hip Arthroplasty: A Multi-Center Retrospective Cohort StudyLu YHu BDai HWang BYao JYao XYi Lu,1,* Bang Hu,2,* Haitao Dai,3,* Bao Wang,1 Jiayin Yao,4 Xinhua Yao1 1Department of Anesthesiology, The Affiliated TCM Hospital of Guangzhou Medical University, Guangzhou, Guangdong Province, People’s Republic of China; 2Department of Colorectal Surgery, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, People’s Republic of China; 3Department of Interventional Radiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, People’s Republic of China; 4Department of Gastroenterology, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, The Sixth Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong Province, People’s Republic of China*These authors contributed equally to this workCorrespondence: Xinhua YaoDepartment of Anesthesiology, The Affiliated TCM Hospital of Guangzhou Medical University, 16th Zhuji Road, Guangzhou, Guangdong Province, 510130, People’s Republic of ChinaTel +86 13719289709Email yxh200210@126.comJiayin YaoDepartment of Gastroenterology, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, The Sixth Affiliated Hospital of Sun Yat-Sen University, 26th Yuancun Second Road, Guangzhou, Guangdong Province, 510655, People’s Republic of ChinaTel +86 13826462890Email yjyin@mail3.sysu.edu.cnBackground: Identifying patients at high risk of developing chronic postsurgical pain (CPSP) is of extreme importance in order to help launch appropriate therapeutic strategies and intensive initiation of pain management.Aim: In this study, we aimed to conduct a multi-center retrospective cohort study to establish a prognostic model and a nomogram to predict the risks of CPSP in elderly patients who underwent hip arthroplasty at 6 months postoperatively.Methods: We collected data from 736 patients aged > 65 years who had undergone hip arthroplasty from October 1, 2016 to September, 30, 2018 at multiple tertiary referral centers in Guangzhou, China. All data were randomly stratified into a training set and a testing set at a ratio of 8:2. Data were analyzed via multiple logistic regression analysis with receiver operating characteristic (ROC) curves and areas under the curve. This model was further validated by estimating calibration and discrimination. A nomogram was ultimately developed.Results: A total of 736 eligible patients were enrolled, 27.20% of whom developed CPSP within 6 months postoperatively. Preoperative pain in the surgical area (OR=2.456, 95% CI:1.814– 3.327, P< 0.001), preoperative depression state (OR=1.256, 95% CI:1.146– 1.378, P< 0.001), surgical type (OR=7.138, 95% CI:3.548– 14.364, P< 0.001), acute postoperative numerical rating scale score (OR=5.537, 95% CI:3.607– 8.499, P< 0.001) and analgesic type (patient-controlled epidural analgesia: OR=0.129, 95% CI:0.055– 0.299, P< 0.001; patient-controlled intravenous analgesia: OR=0.033, 95% CI:0.011– 0.097, P< 0.001) were identified as independent significant factors associated with CPSP. A prognostic model was established and further validated. An ROC curve confirmed the predictive ability of this model with a high sensitivity value of 92.12% (95% CI:86.90– 95.74) and specificity value of 91.72% (95% CI:88.77– 94.11). A nomogram was developed to simplify the use of the predictive model in clinical practice.Conclusion: This prognostic model could be of great value in clinical practice, serving as the basis for early personalized analgesic management of elderly patients undergoing hip arthroplasty.Keywords: chronic postsurgical pain, CPSP, prognostic model, nomogram, retrospective studyhttps://www.dovepress.com/predictors-of-chronic-postsurgical-pain-in-elderly-patients-undergoing-peer-reviewed-fulltext-article-IJGMchronic postsurgical pain (cpsp)prognostic modelnomogramretrospective study |
| spellingShingle | Lu Y Hu B Dai H Wang B Yao J Yao X Predictors of Chronic Postsurgical Pain in Elderly Patients Undergoing Hip Arthroplasty: A Multi-Center Retrospective Cohort Study International Journal of General Medicine chronic postsurgical pain (cpsp) prognostic model nomogram retrospective study |
| title | Predictors of Chronic Postsurgical Pain in Elderly Patients Undergoing Hip Arthroplasty: A Multi-Center Retrospective Cohort Study |
| title_full | Predictors of Chronic Postsurgical Pain in Elderly Patients Undergoing Hip Arthroplasty: A Multi-Center Retrospective Cohort Study |
| title_fullStr | Predictors of Chronic Postsurgical Pain in Elderly Patients Undergoing Hip Arthroplasty: A Multi-Center Retrospective Cohort Study |
| title_full_unstemmed | Predictors of Chronic Postsurgical Pain in Elderly Patients Undergoing Hip Arthroplasty: A Multi-Center Retrospective Cohort Study |
| title_short | Predictors of Chronic Postsurgical Pain in Elderly Patients Undergoing Hip Arthroplasty: A Multi-Center Retrospective Cohort Study |
| title_sort | predictors of chronic postsurgical pain in elderly patients undergoing hip arthroplasty a multi center retrospective cohort study |
| topic | chronic postsurgical pain (cpsp) prognostic model nomogram retrospective study |
| url | https://www.dovepress.com/predictors-of-chronic-postsurgical-pain-in-elderly-patients-undergoing-peer-reviewed-fulltext-article-IJGM |
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