title: Factors Associated With the Development of Chronic Post-Sternotomy Pain: a Case-Control Study.
abstract: OBJECTIVE
  The aim of the present study was to investigate the factors associated with chronic post-sternotomy pain in heart surgery patients.
  
  
  METHODS
  Between January 2013 and February 2014, we evaluated 453 patients with >6 months post-sternotomy for cardiac surgery at a surgical outpatient clinic. The patients were allocated into a group with chronic post-sternotomy pain (n=178) and a control group without pain (n=275). The groups were compared for potential predictors of chronic post-sternotomy pain. We used Cox proportional hazards regression to determine which independent variables were associated with the development of chronic post-sternotomy pain.
  
  
  RESULTS
  In total, 39.29% of the patients had chronic poststernotomy pain. The following factors were significantly associated with chronic post-sternotomy pain: (a) use of the internal thoracic artery in coronary bypass grafting (P =0.009; HR=1.39; 95% CI, 1.08 to 1.80); (b) a history of antidepressant use (P =0.0001; HR=2.40; 95% CI, 1.74 to 3.32); (c) hypothyroidism (P =0.01; HR=1.27; 95% CI, 1.03 to 1.56); (d) surgical wound complication (P =0.01; HR=1.69; 95% CI, 1.08 to 2.63), and (e) patients on disability benefits or scheduled for a consultative medical examination for retirement (P =0.0002; HR=2.05; 95% CI, 1.40 to 3.02).
  
  
  CONCLUSIONS
  The factors associated with chronic poststernotomy pain were: use of the internal thoracic artery; use of antidepressants; hypothyroidism; surgical wound complication, and patients on disability benefits or scheduled for a consultative examination.
authors.affiliation: Universidade Estadual de Ponta Grossa, Ponta Grossa, PR, Brazil.
authors.forename: Mário Augusto Cray da
authors.initials: MA
authors.lastname: Costa
authors.affiliation: Universidade Estadual de Ponta Grossa, Ponta Grossa, PR, Brazil.
authors.forename: Conrado Auer
authors.initials: CA
authors.lastname: Trentini
authors.affiliation: Universidade Estadual de Ponta Grossa, Ponta Grossa, PR, Brazil.
authors.forename: Marcelo Derbli
authors.initials: MD
authors.lastname: Schafranski
authors.affiliation: Santa Casa de Misericórdia de Ponta Grossa, Pronta Gross, PR, Brazil.
authors.forename: Oswaldo
authors.initials: O
authors.lastname: Pipino
authors.affiliation: Universidade Estadual de Ponta Grossa, Ponta Grossa, PR, Brazil.
authors.forename: Ricardo Zanetti
authors.initials: RZ
authors.lastname: Gomes
authors.affiliation: Universidade Estadual de Ponta Grossa, Ponta Grossa, PR, Brazil.
authors.forename: Elise Souza dos Santos
authors.initials: ES
authors.lastname: Reis
mesh_terms: D000368:Aged; D000928:Antidepressive Agents / Q000009:adverse effects; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D016022:Case-Control Studies; D059350:Chronic Pain / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007037:Hypothyroidism / Q000150:complications; D008297:Male; D008323:Mammary Arteries / Q000601:surgery; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology*; D012307:Risk Factors; D056346:Sternotomy / Q000009:adverse effects*; D011795:Surveys and Questionnaires
chemical_list: D000928:Antidepressive Agents