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Genetic and Clinical Factors Associated with Chronic Postsurgical Pain after Hernia Repair, Hysterectomy, and Thoracotomy: A Two-year Multicenter Cohort Study.

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dc.contributor.author Montes Pérez, Antonio
dc.contributor.author Roca, Gisela
dc.contributor.author Sabaté, Sergi
dc.contributor.author Lao, Jose Ignacio
dc.contributor.author Navarro i Cuartiellas, Arcadi, 1969-
dc.contributor.author Cantillo, Jordi
dc.contributor.author Canet, Jaume
dc.contributor.author GENDOLCAT Study Group
dc.date.accessioned 2015-10-13T10:26:33Z
dc.date.available 2016-05-31T02:00:03Z
dc.date.issued 2015
dc.identifier.citation Montes A, Roca G, Sabate S, Lao JI, Navarro A, Cantillo J, et al. Genetic and Clinical Factors Associated with Chronic Postsurgical Pain after Hernia Repair, Hysterectomy, and Thoracotomy: A Two-year Multicenter Cohort Study. Anesthesiology. 2015 May;122(5):1123-41. doi: 10.1097/ALN.0000000000000611.
dc.identifier.issn 0003-3022
dc.identifier.uri http://hdl.handle.net/10230/24836
dc.description.abstract BACKGROUND: Chronic postsurgical pain (CPSP) has been linked to many surgical settings. The authors aimed to analyze functional genetic polymorphisms and clinical factors that might identify CPSP risk after inguinal hernia repair, hysterectomy, and thoracotomy. METHODS: This prospective multicenter cohort study enrolled 2,929 patients scheduled for inguinal hernia repair, hysterectomy (vaginal or abdominal), or thoracotomy. The main outcome was the incidence of CPSP confirmed by physical examination 4 months after surgery. The secondary outcome was CPSP incidences at 12 and 24 months. The authors also tested the associations between CPSP and 90 genetic markers plus a series of clinical factors and built a CPSP risk model. RESULTS: Within a median of 4.4 months, CPSP had developed in 527 patients (18.0%), in 13.6% after hernia repair, 11.8% after vaginal hysterectomy, 25.1% after abdominal hysterectomy, and 37.6% after thoracotomy. CPSP persisted after a median of 14.6 months and 26.3 months in 6.2% and 4.1%, respectively, after hernia repair, 4.1% and 2.2% after vaginal hysterectomy, 9.9% and 6.7% after abdominal hysterectomy, and 19.1% and 13.2% after thoracotomy. No significant genetic differences between cases and controls were identified. The risk model included six clinical predictors: (1) surgical procedure, (2) age, (3) physical health (Short Form Health Survey-12), (4) mental health (Short Form Health Survey-12), (5) preoperative pain in the surgical field, and (6) preoperative pain in another area. Discrimination was moderate (c-statistic, 0.731; 95% CI, 0.705 to 0.755). CONCLUSIONS: Until unequivocal genetic predictors of CPSP are understood, the authors encourage systematic use of clinical factors for predicting and managing CPSP risk.
dc.description.sponsorship This study was supported by grant 071210-2007 from Fundació La Marató de TV3 (Catalan public television network marathon foundation, Barcelona, Spain).
dc.format.mimetype application/pdf
dc.language.iso eng
dc.publisher Lippincott, Williams & Wilkins
dc.rights This is a non-final version of an article published in final form in Montes A, Roca G, Sabate S, Lao JI, Navarro A, Cantillo J, et al. Genetic and Clinical Factors Associated with Chronic Postsurgical Pain after Hernia Repair, Hysterectomy, and Thoracotomy: A Two-year Multicenter Cohort Study. Anesthesiology. 2015 May;122(5):1123-41. doi: 10.1097/ALN.0000000000000611.
dc.subject.other Histerectomia
dc.subject.other Hèrnia
dc.subject.other Dolor postoperatori
dc.title Genetic and Clinical Factors Associated with Chronic Postsurgical Pain after Hernia Repair, Hysterectomy, and Thoracotomy: A Two-year Multicenter Cohort Study.
dc.type info:eu-repo/semantics/article
dc.identifier.doi http://dx.doi.org/10.1097/ALN.0000000000000611
dc.rights.accessRights info:eu-repo/semantics/openAccess
dc.type.version info:eu-repo/semantics/acceptedVersion


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