title: Prevalence of and risk factors for persistent postoperative nonanginal pain after cardiac surgery: a 2-year prospective multicentre study.
abstract: BACKGROUND
  Persistent postoperative pain continues to be an underrecognized complication. We examined the prevalence of and risk factors for this type of pain after cardiac surgery.
  
  
  METHODS
  We enrolled patients scheduled for coronary artery bypass grafting or valve replacement, or both, from Feb. 8, 2005, to Sept. 1, 2009. Validated measures were used to assess (a) preoperative anxiety and depression, tendency to catastrophize in the face of pain, health-related quality of life and presence of persistent pain; (b) pain intensity and interference in the first postoperative week; and (c) presence and intensity of persistent postoperative pain at 3, 6, 12 and 24 months after surgery. The primary outcome was the presence of persistent postoperative pain during 24 months of follow-up.
  
  
  RESULTS
  A total of 1247 patients completed the preoperative assessment. Follow-up retention rates at 3 and 24 months were 84% and 78%, respectively. The prevalence of persistent postoperative pain decreased significantly over time, from 40.1% at 3 months to 22.1% at 6 months, 16.5% at 12 months and 9.5% at 24 months; the pain was rated as moderate to severe in 3.6% at 24 months. Acute postoperative pain predicted both the presence and severity of persistent postoperative pain. The more intense the pain during the first week after surgery and the more it interfered with functioning, the more likely the patients were to report persistent postoperative pain. Pre-existing persistent pain and increased preoperative anxiety also predicted the presence of persistent postoperative pain.
  
  
  CONCLUSIONS
  Persistent postoperative pain of nonanginal origin after cardiac surgery affected a substantial proportion of the study population. Future research is needed to determine whether interventions to modify certain risk factors, such as preoperative anxiety and the severity of pain before and immediately after surgery, may help to minimize or prevent persistent postoperative pain.
authors.forename: Manon
authors.initials: M
authors.lastname: Choinière
authors.forename: Judy
authors.initials: J
authors.lastname: Watt-Watson
authors.forename: J Charles
authors.initials: JC
authors.lastname: Victor
authors.forename: Roger J F
authors.initials: RJ
authors.lastname: Baskett
authors.forename: Jean S
authors.initials: JS
authors.lastname: Bussières
authors.forename: Michel
authors.initials: M
authors.lastname: Carrier
authors.forename: Jennifer
authors.initials: J
authors.lastname: Cogan
authors.forename: Judy
authors.initials: J
authors.lastname: Costello
authors.forename: Christopher
authors.initials: C
authors.lastname: Feindel
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Guertin
authors.forename: Mélanie
authors.initials: M
authors.lastname: Racine
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Taillefer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002170:Canada / Q000453:epidemiology; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D001026:Coronary Artery Bypass / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods*; D010149:Postoperative Pain / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D011446:Prospective Studies; D011788:Quality of Life; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D055815:Young Adult