Post-thoracotomy pain syndrome following thoracotomy at 6- and 12-month follow-ups

Abstract

Limited research has been conducted on the prevalence of chronic pain following thoracotomy in the long term and its associated risk factors within specific populations. The failure to identify the prevalence and risk factors of chronic pain after thoracotomy hinders the implementation of preventive and therapeutic measures. Additionally, the lack of knowledge about the prevalence of this syndrome can result in excessive costs for health systems and non-compliance with additional treatments by patients. Therefore, understanding this syndrome and its risk factors in different populations is crucial. Given the absence of studies in this field for patients in the northwest of Iran, the present study aimed to determine the occurrence of chronic pain syndrome after thoracotomy over 6 and 12 months of follow-up, encompassing all patients over a 12-month period. Material and methods: This prospective cohort study included 160 thoracotomy candidates from Shahid Madani and Imam Reza hospitals, selected using the available sampling method. Clinical information for each patient was recorded, and chronic pain after thoracotomy was identified if the patient reported a pain intensity score of greater than 5 on the Visual Analog Scale (VAS) for two consecutive months. The contribution of each factor to the occurrence of chronic pain after thoracotomy was assessed using multivariate regression analysis. Results: The prevalence of chronic pain after surgery was found to be 21.25%. The study revealed several risk factors associated with chronic pain following thoracotomy. Patients aged over 50 years were 2.29 times more likely to experience chronic pain, while those with a body mass index (BMI) less than 25 had a 2.85 times higher risk. Other significant risk factors included preoperative stress (6.29 times), diabetes mellitus (14.37 times), preoperative depression (8.14 times), preexisting cancer (15.24 times), having more than three preexisting diseases (8.29 times), undergoing thoracic surgery within the last three months (12.44 times), receiving chemotherapy for thoracic cancer (6.96 times), undergoing chest radiotherapy (19.21 times), surgery duration exceeding 3 hours (5.25 times), having a chest tube for more than 4 days (36.5 times), preoperative pain intensity exceeding 5 on the VAS scale (14.32 times), acute pain on the first day after surgery (5.57 times), acute pain on the second day after surgery (29.8 times), and acute pain on the third day after surgery (12.22 times).