BACKGROUND The purpose of this study was to determine the incidence, characteristics, impact, and risk factors associated with persistent incisional pain. The hypothesis was that patient demographics and perioperative interventions are associated with persistent pain. METHODS This was a secondary analysis of an international prospective cohort study from 2012 to 2014. This study included patients who were 45 yr of age or older who underwent major inpatient noncardiac surgery. Data were collected perioperatively and at 1 yr after surgery to assess for the development of persistent incisional pain (pain present around incision at 1 yr after surgery). RESULTS Among 14,831 patients, 495 (3.3%; 95% CI, 3.1 to 3.6) reported persistent incisional pain at 1 yr, with an average pain intensity of 3.6 ± 2.5 (0 to 10 numeric rating scale), with 35% and 14% reporting moderate and severe pain intensities, respectively. More than half of patients with persistent pain reported needing analgesic medications, and 85% reported interference with daily activities (denominator = 495 in the above proportions). Risk factors for persistent pain included female sex (P = 0.007), Asian ethnicity (P < 0.001), surgery for fracture (P < 0.001), history of chronic pain (P < 0.001), coronary artery disease (P < 0.001), history of tobacco use (P = 0.048), postoperative patient-controlled analgesia (P < 0.001), postoperative continuous nerve block (P = 0.010), insulin initiation within 24 h of surgery (P < 0.001), and withholding nonsteroidal anti-inflammatory medication or cyclooxygenase-2 inhibitors on the day of surgery (P = 0.029 and P < 0.001, respectively). Older age (P < 0.001), endoscopic surgery (P = 0.005), and South Asian (P < 0.001), Native American/Australian (P = 0.004), and Latin/Hispanic ethnicities (P < 0.001) were associated with a lower risk of persistent pain. CONCLUSIONS Persistent incisional pain is a common complication of inpatient noncardiac surgery, occurring in approximately 1 in 30 adults. It results in significant morbidity, interferes with daily living, and is associated with persistent analgesic consumption. Certain demographics, ethnicities, and perioperative practices are associated with increased risk of persistent pain. EDITOR’S PERSPECTIVE

中文翻译：

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非心脏手术后持续性切口疼痛：一项国际前瞻性队列研究。

背景本研究的目的是确定与持续性切口疼痛相关的发生率、特征、影响和危险因素。假设是患者人口统计学和围手术期干预与持续性疼痛有关。方法 这是对 2012 年至 2014 年的一项国际前瞻性队列研究的二次分析。该研究包括接受重大住院非心脏手术的 45 岁或以上患者。围手术期和术后 1 年收集数据以评估持续性切口疼痛（术后 1 年切口周围出现疼痛）的发展。结果 在 14,831 名患者中，495 名（3.3%；95% CI，3.1 至 3.6）报告在 1 年时持续存在切口疼痛，平均疼痛强度为 3.6 ± 2.5（0 至 10 数字评分量表），分别有 35% 和 14% 报告中度和重度疼痛强度。超过一半的持续疼痛患者报告需要镇痛药物，85% 报告干扰日常活动（分母 = 495 以上比例）。持续性疼痛的危险因素包括女性（P = 0.007）、亚裔（P <0.001）、骨折手术（P <0.001）、慢性疼痛史（P <0.001）、冠状动脉疾病（P <0.001）、吸烟史（P = 0.048）、术后患者自控镇痛（P <0.001）、术后持续神经阻滞（P = 0.010）、手术后 24 小时内开始使用胰岛素（P <0.001）和停用非甾体抗炎药手术当天服用药物或环氧合酶-2 抑制剂（分别为 P = 0.029 和 P <0.001）。年龄较大（P < 0。001)、内窥镜手术 (P = 0.005) 和南亚人 (P <0.001)、美洲原住民/澳大利亚人 (P = 0.004) 和拉丁裔/西班牙裔 (P <0.001) 与持续性疼痛的风险较低相关。结论 持续性切口疼痛是住院非心脏手术的常见并发症，大约每 30 名成人中就有 1 人发生。它会导致显着的发病率，干扰日常生活，并与持续使用镇痛药有关。某些人口统计学、种族和围手术期实践与持续疼痛的风险增加有关。编辑的观点 结论 持续性切口疼痛是住院非心脏手术的常见并发症，大约每 30 名成人中就有 1 人发生。它会导致显着的发病率，干扰日常生活，并与持续使用镇痛药有关。某些人口统计学、种族和围手术期实践与持续疼痛的风险增加有关。编辑的观点 结论 持续性切口疼痛是住院非心脏手术的常见并发症，大约每 30 名成人中就有 1 人发生。它会导致显着的发病率，干扰日常生活，并与持续使用镇痛药有关。某些人口统计学、种族和围手术期实践与持续疼痛的风险增加有关。编辑的观点