TY - JOUR
T1 - Risk factors for persistent pain after breast and thoracic surgeries
T2 - A systematic literature review and meta-analysis
AU - Lim, Joshua
AU - Chen, Dili
AU - McNicol, Ewan
AU - Sharma, Lokesh
AU - Varaday, Grihith
AU - Sharma, Anshuman
AU - Wilson, Elizabeth
AU - Wright-Yatsko, Tiffany
AU - Yaeger, Lauren
AU - Gilron, Ian
AU - Finnerup, Nanna B.
AU - Haroutounian, Simon
N1 - Publisher Copyright:
© 2021 International Association for the Study of Pain
PY - 2022/1/1
Y1 - 2022/1/1
N2 - Persistent postsurgical pain (PPSP) is common after breast and thoracic surgeries. Understanding which risk factors consistently contribute to PPSP will allow clinicians to apply preventive strategies, as they emerge, to high-risk patients. The objective of this work was to systematically review and meta-analyze the literature on risk factors of PPSP after breast and thoracic surgeries. A systematic literature search using Ovid Medline, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, Embase, PsycINFO, and Scopus databases was conducted. Study screening with inclusion and exclusion criteria, data extraction, and risk of bias assessment was performed independently by 2 authors. The data for each surgical group were analyzed separately and meta-analyzed where possible. The literature search yielded 5584 articles, and data from 126 breast surgery and 143 thoracic surgery articles were considered for meta-analysis. In breast surgery, younger age, higher body mass index, anxiety, depression, diabetes, smoking, preoperative pain, moderate to severe acute postoperative pain, reoperation, radiotherapy, and axillary lymph node dissection were the main factors associated with higher risk of PPSP. In thoracic surgery, younger age, female sex, hypertension, preoperative pain, moderate to severe acute postoperative pain, surgical approach, major procedure, and wound complications were associated with PPSP. This systematic review demonstrated certain consistent risk factors of PPSP after breast and thoracic surgeries, as well as identified research gaps. Understanding the factors that increase susceptibility to PPSP can help selectively allocate resources to optimize perioperative care in high-risk patients and help develop targeted, risk-stratified interventions for PPSP prevention.
AB - Persistent postsurgical pain (PPSP) is common after breast and thoracic surgeries. Understanding which risk factors consistently contribute to PPSP will allow clinicians to apply preventive strategies, as they emerge, to high-risk patients. The objective of this work was to systematically review and meta-analyze the literature on risk factors of PPSP after breast and thoracic surgeries. A systematic literature search using Ovid Medline, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, Embase, PsycINFO, and Scopus databases was conducted. Study screening with inclusion and exclusion criteria, data extraction, and risk of bias assessment was performed independently by 2 authors. The data for each surgical group were analyzed separately and meta-analyzed where possible. The literature search yielded 5584 articles, and data from 126 breast surgery and 143 thoracic surgery articles were considered for meta-analysis. In breast surgery, younger age, higher body mass index, anxiety, depression, diabetes, smoking, preoperative pain, moderate to severe acute postoperative pain, reoperation, radiotherapy, and axillary lymph node dissection were the main factors associated with higher risk of PPSP. In thoracic surgery, younger age, female sex, hypertension, preoperative pain, moderate to severe acute postoperative pain, surgical approach, major procedure, and wound complications were associated with PPSP. This systematic review demonstrated certain consistent risk factors of PPSP after breast and thoracic surgeries, as well as identified research gaps. Understanding the factors that increase susceptibility to PPSP can help selectively allocate resources to optimize perioperative care in high-risk patients and help develop targeted, risk-stratified interventions for PPSP prevention.
KW - Breast surgery
KW - Chronic postsurgical pain
KW - Mastectomy
KW - Meta-analysis
KW - Persistent postsurgical pain
KW - Risk factors
KW - Systematic review
KW - Thoracic surgery
KW - Thoracotomy
UR - http://www.scopus.com/inward/record.url?scp=85122318592&partnerID=8YFLogxK
U2 - 10.1097/j.pain.0000000000002301
DO - 10.1097/j.pain.0000000000002301
M3 - Review article
C2 - 34001769
AN - SCOPUS:85122318592
SN - 0304-3959
VL - 163
SP - 3
EP - 20
JO - Pain
JF - Pain
IS - 1
ER -