A Prospective Study of Chronic Postsurgical Pain in Elderly Patients: Prevalence, Characteristics and Risk factors

Abstract

Abstract Background Considering the continued growth of surgical procedures in older adults and the significant impact of chronic postsurgical pain (CPSP), it is crucial to improve our understanding of the occurrence of CPSP as well as the appropriate prevention and treatment. We therefore conducted this study to determine the prevalence, characteristics and risk factors of CPSP in elderly patients at both 3 and 6 months after surgery. Methods Elderly patients (aged ≥ 60 years) undergoing elective surgery in our institution between April 2018 and March 2020 were prospectively enrolled in this study. Data on demographics, preoperative psychological well-being, intraoperative surgical and anesthesia management, and acute postoperative pain intensity were collected. At 3 and 6 months after surgery, patients received telephone interview and completed the questionnaires regarding chronic pain characteristics, analgesic consumption, and interference of the pain with activities of daily living (ADL). ResultsA total of 1165 elderly patients were followed up for 6 postoperative months and included in final analysis. At 3 and 6 months after operation, the prevalence of CPSP was 35.6% and 21.5 %, respectively. CPSP cause negative impacts on patient’s ADL and most particularly on mood. Neuropathic pain was found in 45.1% of the patients with CPSP at 3 months. At 6 months, 31.0% of those with CPSP reported that the pain had neuropathic features. Preoperative anxiety, preoperative depression, orthopedic surgery, higher pain severity on movement within postoperative 24 h predicted CPSP independently at both 3 and 6 months after surgery. Conclusions CPSP is a common postoperative complication in elderly surgical patients. Predictors for CPSP in the elderly included preoperative anxiety and depression, orthopedic surgery, and greater intensity of acute postoperative pain on movement.