title: Risk factors for acute pain and its persistence following breast cancer surgery.
abstract: Although more severe acute postoperative pain increases the risk of chronic pain following breast cancer surgery, few studies have examined the characteristics of patients who develop greater acute pain. To identify risk factors for acute pain and its persistence one month following breast cancer surgery, a sample of 114 women scheduled for breast cancer surgery was assessed preoperatively for demographic, clinical, and emotional functioning variables that were hypothesized to be associated with acute pain severity. Clinically meaningful postoperative pain was assessed at follow-up interviews 2, 10, and 30 days after surgery. In univariate analyses, the risk of clinically meaningful acute pain was increased among women who were younger, unmarried, had more invasive surgeries, and had greater preoperative emotional distress. In multiple logistic regression analyses, greater preoperative anxiety was the only variable that made an independent contribution to predicting clinically meaningful acute pain at 2 days after surgery whereas younger age, being unmarried, and preoperative anxiety each made an independent contribution to predicting clinically meaningful acute pain that persisted from 2 to 30 days after surgery. These results increase understanding of neurobiologic mechanisms and psychosocial processes that contribute to the development of acute pain following breast cancer surgery and have implications for the development of interventions to prevent it.
authors.affiliation: Department of Psychology, State University of New York College at Geneseo, Geneseo, NY, USA Department of Anesthesiology, School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA Department of Psychiatry, School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA Department of Obstetrics and Gynecology, School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA Department of Surgery, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA Purdue Pharma, Stamford, CT, USA Rochester Psychiatric Center, Rochester, NY, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Katz
authors.forename: Ellen L
authors.initials: EL
authors.lastname: Poleshuck
authors.forename: Carl H
authors.initials: CH
authors.lastname: Andrus
authors.forename: Laura A
authors.initials: LA
authors.lastname: Hogan
authors.forename: Beth F
authors.initials: BF
authors.lastname: Jung
authors.forename: Dale I
authors.initials: DI
authors.lastname: Kulick
authors.forename: Robert H
authors.initials: RH
authors.lastname: Dworkin
mesh_terms: D000208:Acute Disease; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000601:surgery*; D015984:Causality; D015897:Comorbidity; D004522:Educational Status; D005260:Female; D006801:Humans; D017533:Marital Status / Q000706:statistics & numerical data; D008408:Mastectomy / Q000706:statistics & numerical data*; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis* / Q000453:epidemiology*; D015995:Prevalence; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012720:Severity of Illness Index