Prevalence and Predictive Factors of Chronic Postsurgical Pain and Global Surgical Recovery 1 Year After Outpatient Knee Arthroscopy: A Prospective Cohort Study.

Medicine (Baltimore)

From the Department of Anesthesiology and Pain Treatment (DMNH, AAAF, EAJ, H-FG, MAEM, WFFAB); Department of Orthopedic Surgery, Maastricht University Medical Center+, Maastricht, The Netherlands (PJE); and Department of Anesthesiology, ICU and Perioperative Medicine, Hamad Medical Corporation, Qatar (MAEM).

Published: November 2015

AI Article Synopsis

  • Outpatient knee arthroscopy is a common procedure, but many patients experience chronic postsurgical pain (CPSP) and poor global surgical recovery (GSR) one year after surgery.
  • A study of 104 patients showed that 32.7% experienced CPSP, and 50% had poor GSR at the one-year mark, with factors like preoperative pain and analgesic use increasing the risk for CPSP.
  • Early recovery indicators, such as pain levels and quality of life just after surgery, are crucial for predicting long-term outcomes like CPSP and GSR.

Article Abstract

Outpatient knee arthroscopy is one of the most commonly performed surgical procedures. Previous research has demonstrated that chronic postsurgical pain (CPSP) after outpatient surgery is prevalent. Our objective was to determine the prevalence and predictive factors of CPSP and Global Surgical Recovery (GSR) 1 year after knee arthroscopy.A prospective longitudinal cohort study was performed. Patients were included during an 18-month period. Data were collected by using 3 questionnaires: at 1 week preoperatively, 4 days postoperatively, and 1 year postoperatively. A value of >3 on an 11-point numeric rating scale (NRS) was defined as moderate to severe pain. A score of ≤80% on the Global Surgical Recovery Index was defined as poor GSR. Stepwise logistic regression analysis was performed to determine which variables were predictors for CPSP and poor GSR.The prevalence of moderate to severe preoperative pain in patients undergoing knee arthroscopy (n = 104) was 71.2%, of acute postsurgical pain 37.5%, and of CPSP 32.7%. Risk factors for CPSP were the presence of preoperative pain and preoperative analgesic use, with odds ratios of 6.31 (1.25-31.74) and 4.36 (1.58-12.07), respectively. The prevalence of poor GSR 1 year after outpatient knee arthrosocpy was 50.0%. Poor GSR 4 days after the surgery was a risk factor with an odds ratio of 8.38 (0.92-76.58) and quality of life 4 days after surgery was a protective factor with and odds ratio of 0.10 (0.02-0.64).Both CPSP and poor GSR are common 1 year after knee arthroscopy. Patients at risk for CPSP can be identified during the preoperative phase. Prediction of poor GSR 1 year after surgery is mainly related to early postoperative recovery.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4912294PMC
http://dx.doi.org/10.1097/MD.0000000000002017DOI Listing

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