The Incidence and Severity of Postoperative Pain following Inpatient Surgery.
OBJECTIVE
In recent years, there has been increased attention to pain management after surgery in the hospital setting along with financial enticement from the US government. The aim of this study is to evaluate the current efficacy of postoperative pain management.


METHODS
In a prospective study, patients in an academic private nonprofit medical center were asked the same questions about their postoperative pain as in a previously published 2003 survey. Questionnaires on 1) pain intensity on a verbal categorical scale and 2) patient satisfaction with pain medication were completed in the patient's room before hospital discharge, and followed-up by telephone interviews at 1 and 2 weeks later. Numerical Pain Scale (NRS) pain scores were obtained at the same time points. Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) results for pain management were obtained at bedside interview along with standard mailed HCAHPS survey obtained by Press Ganey.


RESULTS
Based on 441 surgical inpatients (Orthopedic, General, Neurosurgery, Gynecological) 12% of patients had "Severe-to-Extreme" pain and 54% had "Moderate-to-Extreme" pain at discharge. During the first 2 weeks after discharge, 13% of patients had "Severe-to-Extreme" pain and 46% had "Moderate-to-Extreme" pain. Pain scores at discharge and after discharge were negatively correlated with patient satisfaction with pain medication (P < 0.0001), indicating that increased pain intensity was associated with decreased patient satisfaction. For the HCAHPS question "how often was your pain well controlled?," 66% answered "Always" in the Press Ganey report versus 51% at bedside (P < 0.0001).


CONCLUSIONS
The incidence of severe-to-extreme pain in patients before and after discharge following inpatient surgery is 12-13%, and this is a reduction from 10 years ago.
Department of Anesthesiology, Rush Medical College, Chicago, Illinois, USA.
Asokumar
A
Buvanendran
Department of Anesthesiology, Rush Medical College, Chicago, Illinois, USA.
Jacqueline
J
Fiala
Department of Anesthesiology, Rush Medical College, Chicago, Illinois, USA.
Karishma A
KA
Patel
Department of Anesthesiology, Rush Medical College, Chicago, Illinois, USA.
Alexandra D
AD
Golden
Department of Anesthesiology, Rush Medical College, Chicago, Illinois, USA.
Mario
M
Moric
Department of Anesthesiology, Rush Medical College, Chicago, Illinois, USA.
Jeffrey S
JS
Kroin
D000203:Activities of Daily Living; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002641:Chicago / Q000453:epidemiology; D059026:Diagnostic Self Evaluation; D005260:Female; D013502:General Surgery / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000706:statistics & numerical data*; D010149:Postoperative Pain / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution; D055815:Young Adult
HCAHPS; Patient Satisfaction; Postsurgical Pain; Survey