「经典文献阅读」术后并发症与术后持续性疼痛的相关性：一项多中心前瞻性队列研究

2022-03-06 21:42:53 来源：九派健康收藏

Association of postoperative complications with persistent postsurgical pain: a multicentre prospective cohort study.

术后并发症与术后持续性疼痛的相关性：一项多中心前瞻性队列研究

Background: Persistent post-surgical pain is an important and under-recognised problem that is difficult to treat. Postoperative complications have been identified as possible risk factors for persistent post-surgical pain. We conducted a secondary analysis of the Measurement of Exercise Tolerance before Surgery (METS) cohort study to characterise the association of major postoperative complications with post-surgical pain at 30 days and 1 yr after major surgery.

背景：术后持续性疼痛是一个重要且未得到充分认识的难以治疗的问题。术后并发症已被确定为手术后持续性疼痛的可能危险因素。我们对术前运动耐量(METS)队列研究进行了二次分析，以确定大手术后30天和1年的主要术后并发症与持续性术后疼痛之间是否存在相关性。

Methods: The analysis included 1313 participants (?40 yr old) who had inpatient noncardiac surgery and survived for 1 yr. The co-primary outcomes were 30-day post-surgical pain and 1-yr post-surgical pain. Post-surgical pain was defined as pain or discomfort that was of moderate or severe intensity (EuroQoL-5D [EQ-5D] instrument) and unimproved compared with preoperative pain or discomfort. The principal exposure was major in-hospital complications (moderate or severe by modified ClavieneDindo criteria). Multivariable logistic regression modelling was used to characterise the adjusted association of major complications with outcomes.

方法：本研究纳入了1313名(≥40岁)住院的非心脏手术且术后存货至少1年的患者，主要结果是术后30天和术后1年的疼痛。术后疼痛定义为中度、重度疼痛或不适(采用EuroQol-5D分析)，且与术前疼痛或不适相比无改善。术后住院期间的并发症并发症(根据改良的Clavien-Dindo标准定义为中度或重度事件)。使用多变量Logistic回归模型来分析主要并发症与校正后的术后持续疼痛之间的相关性。

Results: Of the cohort, 12% (n163) experienced major complications, 51% (n674) reported 30-day post-surgical pain, and 42% (n545) reported 1-yr post-surgical pain. Major complications were associated with 30-day post-surgical pain (adjusted odds ratio [aOR]1.54; 95% confidence interval [CI], 1.05e2.23) and possibly 1-yr post-surgical pain (aOR1.42; 95% CI, 0.98e2.06). When analyses were repeated after multiple imputation of missing covariate and outcome data, complications were associated with both 30-day and 1-yr post-surgical pain.

结果：在队列中，12%(n/163)出现了主要并发症，51%(n/674)报告了术后30天的疼痛，42%(n/545)报告了手术后1年的疼痛。主要并发症与术后30天的疼痛(调整后的优势比[aOR]=1.54；95%可信区间[CI]，1.05-2.23)和可能的术后1年疼痛有关(调整后的优势比[aOR]=1.42；95%可信区间[CI]，0.98e2.06)。对缺失的协变量和结局数据进行多变量回归分析，主要并发症与术后30天和1年的疼痛相关。

Conclusions: Patients who developed major complications were more likely to report pain at 30 days and possibly 1 year after surgery. Research is necessary to validate thesefindings and delineate underlying mechanisms.

结论：术后出现主要并发症的患者更有可能在术后30天和术后1年发生疼痛。有必要进行研究来验证这些发现并描述出潜在的机制。

主要数据分析结果：

END 原文文档

笔记：差劲先森。

排版：肉肉

【来源：中国网医疗频道】

关键词：队列研究可信区间

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