A multicenter analysis of registry data on postoperative orthopedic pain: a retrospective cohort study

Abstract

Abstract Background Postoperative pain has significant implications, including surgical complications, prolonged hospital stays, and increased healthcare costs. The severity of postoperative pain depends predominantly on the surgical procedure, with orthopedic surgeries posing an elevated risk for severe pain. This study aimed to identify orthopedic surgical procedures that induce severe pain in hospitalized patients within the first 72 hours after surgery. Methods We retrospectively analysed nurse-recorded pain scores from patients who received inpatient orthopaedic surgery between October 15, 2015, and December 31, 2019, in three different hospitals. Patient and procedure characteristics and the highest numeric rating scale for pain were collected up to 72 hours after surgery. Procedures were coded according to the International Classification of Health Interventions and subsequently ranked based on the highest median numerical rating scale for pain. Results A total of 9.918 patients were included in the analysis. The median highest pain score between 3 and 24 hours and between 24 and 48 hours postoperatively was 4 (IQR 3). The median highest pain score between 48 and 72 hours postoperatively was 3 (IQR 2). Open reduction and implantation of the device into the humerus (e.g., plate fixation) ranked highest, with a median NRS for pain of 6 (IQR 3) in the 3- to 48-hour postoperative period and a median NRS of 5 (IQR 3) in the 48- to 72-hour postoperative period. Open procedures of the shoulder joint, open ankle procedures and open fusion of the lumbar spine were among the top ten procedures with the highest median pain scores. Conclusions Patients who underwent surgery involving the humerus, shoulder, or lumbar spine had greater pain scores. Further analysis, including the inclusion of analgesic medication data, can contribute to a better understanding of effective interventions for managing postoperative pain for these specific procedures. Trial registration The study received formal ethical approval from the ethical committee and the institutional research review board of OLVG Hospital on April 25, 2017, with reference number ACWO-MEC 17u.207/WCHJ/WO 17.051.