Psychosocial predictors and correlates for chronic post-surgical pain (CPSP) – A systematic review

Abstract Chronic post-surgical pain (CPSP) is a serious problem. Incidence as high as 50% has been reported, depending on type of surgery undergone. Because the etiology of chronic pain is grounded in the bio-psychosocial model, physical, psychological, and social factors are implicated in the devel...

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Bibliographic Details
Published in:European journal of pain 2009-08, Vol.13 (7), p.719-730
Main Authors: Hinrichs-Rocker, Anke, Schulz, Kerstin, Järvinen, Imke, Lefering, Rolf, Simanski, Christian, Neugebauer, Edmund A.M
Format: Article
Language:English
Subjects:
Anesthesia & Perioperative Care
Bio-psychosocial model
Chronic Disease
Chronic pain
Chronic post-surgical pain (CPSP)
Databases, Factual
Depression - complications
Depression - psychology
Humans
Pain Medicine
Pain, Postoperative - epidemiology
Pain, Postoperative - psychology
Post-operative pain
Prediction
Predictive Value of Tests
Risk factor
Risk Factors
Socioeconomic Factors
Stress, Psychological
Surgical Procedures, Operative
Work
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Summary:Abstract Chronic post-surgical pain (CPSP) is a serious problem. Incidence as high as 50% has been reported, depending on type of surgery undergone. Because the etiology of chronic pain is grounded in the bio-psychosocial model, physical, psychological, and social factors are implicated in the development of CPSP. Biomedical factors such as pre-operative pain, severe acute post-operative pain, modes of anesthesia, and surgical approaches have been extensively examined, therefore this systematic review focuses on psychosocial elements. A systematic search was performed using the PubMed, PsychINFO, Embase, and Cochrane Databases. Fifty relevant publications were selected from this search, in which psychosocial predictors for and correlates to CPSP were identified. The level of evidence was assessed for each study, and corresponding score points were awarded for ease of comparison. The grade of association with CPSP for each predictor/correlate was then determined. Depression, psychological vulnerability, stress, and late return to work showed likely correlation with CPSP (grade of association = 1). Other factors were determined to have either unlikely (grade of association = 3) or inconclusive (grade of association = 2) correlations. In addition, results were examined in light of the type of surgery undergone. This review is intended as a first step to develop an instrument for identifying patients at high risk for CPSP, to optimize clinical pain management.
ISSN:1090-3801
1532-2149
DOI:10.1016/j.ejpain.2008.07.015