title: The impact of early postoperative pain on health-related quality of life.
abstract: OBJECTIVE
  To examine how the severity of postoperative pain affects patient's health-related quality of life (HRQoL) at 1 week following surgery and to compare two generic validated HRQoL instruments.
  
  
  METHODS
  Patients undergoing general or orthopaedic surgery at the Royal London Hospital were randomly sampled. The following patient outcome data were collected EQ-5D (EuroQoL) pre-operatively and the Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R) at 24 hours postoperation; and EQ-5D, Short-Form-12 (SF-12) and APS-POQ-R at 7 days postoperation. The degree of association between pain and HRQoL was assessed using Pearson's correlation coefficient and multivariate generalized linear regression models.
  
  
  RESULTS
  Of the 228 patients included, 166 patients provided data at 7 days. Sixteen percent reported severe pain ≥ 50% of the day at 7 days. The severity of pain on both the APS-POQ-R pain severity and interference and affective impairment domains at 7 days was highly correlated with a decrease in HRQoL as assessed by the SF-12 Physical Component Score (PCS), SF-12 Mental Component Score (MCS), and EQ-5D scores (r = -0.34 to -0.61, P < 0.0001). Multivariate regression analyses showed that irrespective of confounding factors (eg, age, gender, and pre-operative HRQoL) patients with severe postoperative pain experience important reductions in both physical and mental well-being domains of their HRQoL.
  
  
  CONCLUSIONS
  A proportion of patients continue to experience severe pain at 7 days postoperatively, even after minor surgery. HRQoL is strongly associated with the level of pain and provides additional data on the impact of postsurgery pain on patient's function and well-being. Additional studies are needed to elucidate the interaction between pain severity and HRQoL during the peri-operative period.
authors.affiliation: Peninsula Medical School, University of Exeter, Exeter, UK. rod.taylor@pms.ac.uk
authors.forename: Rod S
authors.initials: RS
authors.lastname: Taylor
authors.forename: Kristin
authors.initials: K
authors.lastname: Ullrich
authors.forename: Sophie
authors.initials: S
authors.lastname: Regan
authors.forename: Christina
authors.initials: C
authors.lastname: Broussard
authors.forename: Matthias
authors.initials: M
authors.lastname: Schwenkglenks
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Taylor
authors.forename: Debra B
authors.initials: DB
authors.lastname: Gordon
authors.forename: Ruth
authors.initials: R
authors.lastname: Zaslansky
authors.forename: Winfried
authors.initials: W
authors.lastname: Meissner
authors.forename: Judith
authors.initials: J
authors.lastname: Rothaug
authors.forename: Richard
authors.initials: R
authors.lastname: Langford
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires; D013997:Time Factors
keywords: HRQoL; PAIN-OUT; acute pain service; health-related quality of life; postoperative pain