BACKGROUND Post-surgical pain that lingers beyond the initial few-week period of tissue healing is a major predictor of pain chronification, which leads to substantial disability and new persistent opioid analgesic use. We investigated whether postoperative medical complications increase the risk of lingering post-surgical pain. METHODS The study population consisted of patients undergoing diverse elective surgical procedures in an academic referral centre in the USA, between September 2013 and May 2017. Multivariable logistic regression, adjusting for confounding variables and patient-specific risk factors, was used to test for an independent association between any major postoperative complication and functionally limiting lingering pain 1-3 months after surgery, as obtained from patient self-reports. RESULTS The cohort included 11 986 adult surgical patients; 10 562 with complete data. At least one complication (cardiovascular, respiratory, renal/gastrointestinal, wound, thrombotic, or neural) was reported by 13.3% (95% confidence interval: 12.7-14.0) of patients, and 19.7% (19.0-20.5%) reported functionally limiting lingering post-surgical pain. After adjusting for known risk factors, the patients were twice as likely (odds ratio: 2.04; 1.78-2.35) to report lingering post-surgical pain if they also self-reported a postoperative complication. Experiencing a complication was also independently predictive of lingering post-surgical pain (odds ratio: 1.95; 1.26-3.04) when complication data were extracted from the National Surgical Quality Improvement Program registry, instead of being obtained from patient self-report. CONCLUSIONS Medical complications were associated with a two-fold increase in functionally limiting pain 1-3 months after surgery. Understanding the mechanisms that link complications to pathological persistence of pain could help develop future approaches to prevent persistent post-surgical pain.

中文翻译：

---

术后并发症与持续的术后疼痛之间的关联：一项观察性队列研究。

背景技术在组织愈合的最初几周内持续存在的手术后疼痛是疼痛发作时间的主要预测因素，其导致严重的残疾和新的持续性阿片类镇痛药的使用。我们调查了术后医疗并发症是否增加了术后疼痛持续存在的风险。方法该研究人群由2013年9月至2017年5月在美国学术转诊中心接受多种选择性外科手术的患者组成。采用多变量logistic回归，对混杂变量和患者特定的危险因素进行了调整，以检验其独立性。术后1-3个月内任何重大术后并发症与功能受限的持续疼痛之间的关联，如从患者自我报告中获得的那样。结果该队列包括11 986名成人手术患者；10562个完整的数据。据报告，至少有一种并发症（心血管，呼吸，肾脏/胃肠道，伤口，血栓形成或神经并发症）发生在13.3％（95％置信区间：12.7-14.0）患者中，而19.7％（19.0-20.5％）则是功能受限的患者。持续的术后疼痛。在调整了已知的危险因素后，如果患者还自我报告了术后并发症，则他们有两倍的机会报告手术后疼痛持续存在（赔率：2.04； 1.78-2.35）。当从国家外科质量改善计划注册中心而不是从患者自我报告中获得并发症数据时，经历并发症也可以独立预测手术后疼痛的持续时间（赔率：1.95； 1.26-3.04）。结论手术后1-3个月，医疗并发症与功能受限疼痛增加了两倍有关。了解将并发症与疼痛的病理性持久性联系起来的机制可能有助于开发预防未来手术后持久性疼痛的方法。