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Archives of Orthopaedic and Trauma Surgery

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01-12-2017 | Orthopaedic Surgery

Pain catastrophizing as a predictor for postoperative pain and opiate consumption in total joint arthroplasty patients

Authors: David Wright, Melinda Hoang, Anna Sofine, Jack P. Silva, Ran Schwarzkopf

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 12/2017

Abstract

Background

Pain catastrophizing has been suggested as a prospective risk factor for poor postoperative pain outcomes in total joint arthroplasty (TJA). However, results from the previous studies have been mixed and have not controlled for postoperative opiate analgesic intake. This study investigates pain catastrophizing and postoperative pain intensity in TJA patients, adjusting for analgesic intake. We hypothesized that “pain catastrophizers” would exhibit higher pain scores and increased analgesic requirements postoperatively.

Methods

In this prospective cohort study, patients were defined as catastrophizers (PCS > 30), or non-catastrophizers (PCS ≤ 30). The primary outcome was the visual analog scale (VAS) pain score at 3-month follow-up. Secondary outcomes included length of stay (LOS) for the index hospitalization, total daily opiate analgesic intake, and VAS pain scores on postoperative days 0, 1, 2, and 3 through discharge. Multivariable regression was used to control for total daily morphine equivalent dose consumed during the stay in addition to other clinical and demographic factors.

Results

There were 87 patients in the “non-catastrophizing” and 36 in the “catastrophizing” groups. There was no clinically significant difference in VAS pain scores between groups at 3-month follow-up. Patients with a length of stay (LOS) ≥ 3 postoperative days differed in VAS pain scores (“non-catastrophizers” = 5.08 vs. “catastrophizers” = 7.13; p = 0.002) and were 2.4 times more likely to be catastrophizers than non-catastrophizers (p = 0.042). There were no differences in the remaining secondary outcomes.

Conclusion

The pain catastrophizing scale is a poor predictor of postoperative pain at 3-month follow-up. However, it may be a risk factor for increased LOS.

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Title: Pain catastrophizing as a predictor for postoperative pain and opiate consumption in total joint arthroplasty patients
Authors: David Wright
Melinda Hoang
Anna Sofine
Jack P. Silva
Ran Schwarzkopf
Publication date: 01-12-2017
Publisher: Springer Berlin Heidelberg
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 12/2017
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-017-2812-x

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Pain catastrophizing as a predictor for postoperative pain and opiate consumption in total joint arthroplasty patients

Abstract

Background

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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