| Title: | The preoperative risk factors of chronic postsurgical pain: a retrospective cohort study in the UK Biobank. |
| Journal: | International Journal of Surgery |
| Published: | 11 Nov 2025 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/41231633/ |
| DOI: | https://doi.org/10.1097/js9.0000000000003831 |
Publication 18969
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Abstract
BACKGROUND: Lacking preoperative chronic postsurgical pain (CPSP) risk factors that cover all surgical modalities, are based on large-scale databases, and are free from patients' subjective elements and compliance.</p>
MATERIALS AND METHODS: This study utilized the UK Biobank, whose baseline assessment was conducted between 2006 and 2010. It centered on participants who responded to the CPSP questionnaire during January to February 2019. In conjunction with previous reviews, 67 potential risk factors were identified and categorized into 10 domains. The Cox proportional hazards regression model was employed to analyze the relationships between these factors and CPSP. Finally, interaction and sensitivity analyses were performed to mitigate biases arising from potential reverse causalities among the risk factors, as well as the matching of the operation time with the CPSP occurrence time and data imputation.</p>
RESULTS: Of 125 939 included participants with 74 046 (58.8%) women and 56.8 years mean age at baseline, 3609 incident CPSP cases were observed. After stepwise Cox regression, 21 factors were significantly associated with a higher CPSP risk. Among them, 15 factors demonstrated a significant association with increased CPSP risk ( P < 0.001). These factors include older age, obesity, lower educational attainment, lower income, a higher surgery times before baseline, elevated polygenic risk score, insufficient sleep, smoking, longer time spent outdoors in summer or winter, maternal smoking around birth, chronic condition or disability, regular analgesic use, and elevated cystatin C and gamma-glutamyltransferase. Additionally, high-sodium diets, higher mismatched count, hypertension, and related hematological indicators such as increased mean corpuscular hemoglobin concentration, red blood cell distribution width (RDW), and monocyte count were also found to significantly elevate the risk of CPSP ( P < 0.05).</p>
CONCLUSIONS: Our findings contribute to a more comprehensive understanding of CPSP risk factors and pathogenesis, which hold significant implications for developing targeted preventive strategies, optimizing perioperative pain management, and improving the allocation of healthcare resources.</p>
14 Keywords
- Adult
- Aged
- Biological Specimen Banks
- Chronic Pain
- Female
- Humans
- Male
- Middle Aged
- Postoperative Pain
- Preoperative Period
- Retrospective Studies
- Risk Factors
- UK Biobank
- United Kingdom
18 Authors
- Tumaresi Batuer
- Yundi Hu
- Fan Wu
- Runye Shi
- Haojing Duan
- Jiehui Liu
- Yanzi Lian
- Junjun Yang
- Yuwen Zhang
- Jingya Zhang
- Xue Du
- Xuanran Feng
- Yiyan Sun
- Diksha Basnet
- Caiyun Xi
- Changqi Chen
- Xiaolei Lin
- Jianhui Liu
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