Dataset Information

Using four different clinical tools as predictors for pain after total hip arthroplasty: a prospective cohort study.

ABSTRACT:

Background

Treatment of postoperative pain remains a significant clinical problem, and prediction of patients with a risk of higher postoperative pain levels is an important focus. We aimed to identify patients undergoing total hip arthroplasty (THA) with risk of higher pain levels at 24 h postoperatively by using four simple and easily available clinical tools.

Methods

This prospective observational cohort study included 102 patients having THA at Zealand University Hospital in Denmark. The following predictive tools were investigated for identifying patients with higher postoperative pain levels at 24 h postoperatively, both at rest and during mobilization: preoperative pain by peripheral venous cannulation (PVC) (dichotomized according to numerical rating scale pain ≤ 2/> 2 (PVC-Low/PVC-High) (primary outcome); the post anesthesia care unit (PACU) nurses' expectations of patients pain levels; patients early pain levels at the PACU; and patients own forecast of postoperative pain levels. The Mann-Whitney U test was used to analyze comparisons between prediction groups. For the primary outcome we considered a p-value < 0.01 as statistically significant and for other outcomes a p-value of 0.05.

Results

We found no significant differences between the PVC groups for pain during mobilization at 24-h postoperatively: PVC-Low: 6 (4-8) (median, (IQR)) versus PVC-High: 7 (5-8) (median, (IQR)), p = 0.10; and for pain at rest: PVC-Low 2 (0-3) (median, (IQR)) versus PVC-High 3 (2-5) (median, (IQR)), p = 0.12. Other comparisons performed between predictive groups did not differ significantly.

Conclusions

In this prospective cohort study of 102 THA patients, we did not find that preoperative pain by PVC, when using a cut-off point of NRS ≤ 2, were able to predict postoperative pain at 24 h postoperatively. Neither did PACU nurses' prediction of pain, patients forecast of pain, nor did maximum pain levels at the PACU.

Trial registration

Retrospectively registered 20th February 2018 at ClinicalTrials.gov (NCT03439566).

SUBMITTER: Geisler A

PROVIDER: S-EPMC7055106 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Publications

Using four different clinical tools as predictors for pain after total hip arthroplasty: a prospective cohort study.

Geisler Anja A Zachodnik Josephine J Laigaard Jens J Kruuse Laura S LS Sørensen Charlotte V CV Sandberg Magnus M Persson Eva I EI Mathiesen Ole O

BMC anesthesiology 20200303 1

<h4>Background</h4>Treatment of postoperative pain remains a significant clinical problem, and prediction of patients with a risk of higher postoperative pain levels is an important focus. We aimed to identify patients undergoing total hip arthroplasty (THA) with risk of higher pain levels at 24 h postoperatively by using four simple and easily available clinical tools.<h4>Methods</h4>This prospective observational cohort study included 102 patients having THA at Zealand University Hospital in D ...[more]

PMID: 32126971

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Project description:BackgroundThe growing number of patients undergoing total hip arthroplasty (THA) and postoperative outcomes receive increasing attention from doctors and patients. This study aimed to elucidate the effects of comorbidities on postoperative function, pain, complications, readmission rate, and mortality.MethodsWe included consecutive patients who underwent primary unilateral THA between 2017 and 2019. The Charlson comorbidity index (CCI) and the WOMAC and SF-36 (physical function, body pain) scales were assessed preoperatively and at 3, 6, 12, and 24 months postoperatively. The complications, 30-day readmission, and mortality rates assessed the impact of comorbidities and their changes over time on the WOMAC and SF-36 scores during follow-up. We used mixed model linear regression to examine the association of worsening comorbidity post-THA with change in WOMAC and SF-36 scores in the subsequent follow-up periods, controlling for age, length of follow-up, and repeated observations.ResultsThis study included 468 patients, divided into four groups based on comorbidity burden (CCI-0, 1, 2, and ≥3). The physiological function recovery and pain scores in the CCI ≥ 3 group were inferior to the other groups and took longer than the other groups (6 vs. 3 months) to reach their best level. The four groups preoperative waiting times were 2.41 ± 0.74, 2.97 ± 0.65, 3.80 ± 0.53, and 5.01 ± 0.71 days, respectively. The complications, 30-day readmission, and 1-year mortality rates for the overall and the CCI ≥ 3 group were 1.92% and 4.69%, 0.85% and 2.01%, and 0.43% and 1.34%, respectively, with no mortality in the other groups.ConclusionPatients with higher CCI were more susceptible to physical function and pain outcome deterioration, experienced longer waiting time before surgery, took longer to recover, and had higher rates of complications, 30-day readmission, and mortality after THA. Older age in the group led to a greater impact.

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Dataset Information

Using four different clinical tools as predictors for pain after total hip arthroplasty: a prospective cohort study.

Background

Methods

Results

Conclusions

Trial registration

Publications

Using four different clinical tools as predictors for pain after total hip arthroplasty: a prospective cohort study.

Similar Datasets

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