title: Procedure-specific risk factor analysis for the development of severe postoperative pain.
abstract: BACKGROUND
  Many studies have analyzed risk factors for the development of severe postoperative pain with contradictory results. To date, the association of risk factors with postoperative pain intensity among different surgical procedures has not been studied and compared.
  
  
  METHODS
  The authors selected precisely defined surgical groups (at least 150 patients each) from prospectively collected perioperative data from 105 German hospitals (2004-2010). The association of age, sex, and preoperative chronic pain intensity with worst postoperative pain intensity was studied with multiple linear and logistic regression analyses. Pooled data of the selected surgeries were studied with random-effect analysis.
  
  
  RESULTS
  Thirty surgical procedures with a total number of 22,963 patients were compared. In each surgical procedure, preoperative chronic pain intensity and younger age were associated with higher postoperative pain intensity. A linear decline of postoperative pain with age was found. Females reported more severe pain in 21 of 23 surgeries. Analysis of pooled surgical groups indicated that postoperative pain decreased by 0.28 points (95% CI, 0.26 to 0.31) on the numeric rating scale (0 to 10) per decade age increase and postoperative pain increased by 0.14 points (95% CI, 0.13 to 0.15) for each higher score on the preoperative chronic pain scale. Females reported 0.29 points (95% CI, 0.22 to 0.37) higher pain intensity.
  
  
  CONCLUSIONS
  Independent of the type and extent of surgery, preoperative chronic pain and younger age were associated with higher postoperative pain. Females consistently reported slightly higher pain scores regardless of the type of surgery. The clinical significance of this small sex difference has to be analyzed in future studies.
authors.affiliation: From the Department of Anesthesiology and Intensive Care Medicine, University Medical Center Utrecht, Utrecht, The Netherlands (H.J.G., A.J.M.v.W., L.M.P., T.H.K., and C.J.K.); Department of Anesthesiology, Intensive Care Medicine, and Pain Therapy, University of Münster, Münster, Germany (E.P.-Z.); Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands (L.M.P.); Department of Anesthesiology and Intensive Care Medicine, University of Cologne, Cologne, Germany (S.A.); and Department of Anesthesiology and Intensive Care Medicine, Jena University Hospital, Jena, Germany (W.M.).
authors.forename: Hans J
authors.initials: HJ
authors.lastname: Gerbershagen
authors.forename: Esther
authors.initials: E
authors.lastname: Pogatzki-Zahn
authors.forename: Sanjay
authors.initials: S
authors.lastname: Aduckathil
authors.forename: Linda M
authors.initials: LM
authors.lastname: Peelen
authors.forename: Teus H
authors.initials: TH
authors.lastname: Kappen
authors.forename: Albert J M
authors.initials: AJ
authors.lastname: van Wijck
authors.forename: Cor J
authors.initials: CJ
authors.lastname: Kalkman
authors.forename: Winfried
authors.initials: W
authors.lastname: Meissner
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000175:diagnosis* / Q000453:epidemiology*; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult