title: Predictors of acute postsurgical pain and anxiety following primary total hip and knee arthroplasty.
abstract: This study aims to examine the joint role of demographic, clinical, and psychological variables as predictors of acute postsurgical pain and anxiety in patients undergoing total knee arthroplasty and total hip arthroplasty. A consecutive sample of 124 patients was assessed 24 hours before (T1) and 48 hours after (T2) surgery. Demographic, clinical, and psychological factors were assessed at T1 and several postsurgical pain issues, anxiety, and analgesic consumption were evaluated at T2. Hierarchical linear regression analyses were performed to identify predictors of acute pain and anxiety following surgery. In the final multivariate model, presurgical optimism emerged as the main significant predictor of postsurgical pain intensity. Presurgical optimism also had a significant role in the prediction of postsurgical anxiety, together with presurgical anxiety level and emotional representation of the condition leading to surgery (osteoarthritis). A significant positive correlation between postsurgical anxiety and acute pain was also confirmed. The present study enhances our understanding of predictors of acute pain and anxiety following total knee arthroplasty and total hip arthroplasty by showing the relevance of psychological factors, over and above other potential clinical predictors. These findings could be used to develop targeted interventions aimed at acute postsurgical pain and anxiety management following major joint arthroplasties.
  
  
  CONCLUSIONS
  This article reveals the significant influence of psychological factors on the prediction of acute pain and anxiety 48 hours after primary total hip and knee arthroplasty. These results could prove useful for the design of interventions aimed at postsurgical pain and anxiety management.
authors.affiliation: Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal.
authors.forename: Patrícia R
authors.initials: PR
authors.lastname: Pinto
authors.forename: Teresa
authors.initials: T
authors.lastname: McIntyre
authors.forename: Ramón
authors.initials: R
authors.lastname: Ferrero
authors.forename: Armando
authors.initials: A
authors.lastname: Almeida
authors.forename: Vera
authors.initials: V
authors.lastname: Araújo-Soares
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000209:etiology* / Q000523:psychology; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects*; D058443:Catastrophization / Q000209:etiology / Q000523:psychology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000209:etiology* / Q000523:psychology; D010465:Perception; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult