Association of Post-Traumatic Growth and Analgesic Use in Postoperative Patients

Background: Post-traumatic growth (PTG) refers to positive psychological changes experienced after traumatic events. The post-traumatic growth inventory-expanded (PTGI-X) measures PTG across five subscales, with higher scores indicating greater PTG. This study investigated factors influencing postoperative PTGI-X score and its impact on postoperative analgesic use and quality of life. Methods: This prospective observational study enrolled adult patients scheduled for chest surgery for malignant mediastinal and lung tumors, excluding those with prior psychological disorders, severe obesity, or cognitive impairment. PTGI-X, Hospital anxiety depression scale (HADS), EuroQol 5-dimension 3-level (EQ-5D-3L) questionnaire, and Brief pain inventory (BPI) were used for assessments. PTGI-X was measured 30 days post-surgery, HADS was measured before surgery, EQ-5D-3L was measured pre- and 30 days post-surgery, and BPI was assessed at variable pre-and post-surgery time points over 30 days. Linear regression analyses were performed to explore perioperative factors associated with PTGI-X score as the primary outcome. Secondary outcomes included logistic regression analysis with PTGI-X score as explanatory variable for the need of postoperative analgesic medication on day 30, as well as linear regression analysis with PTGI-X score as explanatory variable for changes in EQ-5D-3L scores. Results: Of 144 eligible patients, 120 completed the 1-month follow-up. Median PTGI-X score was 56.5 (interquartile range: 37.5, 76). Preoperative anxiety (HADS subscale for anxiety≥8) was significantly associated with PTGI-X score (coefficient (95% confidence interval): 17.12 (5.44, 28.81)). PTGI-X score (odds ratio (95% confidence interval): 0.76 (0.62, 0.94)) and significant postoperative pain were independently associated with postoperative analgesic medication. PTGI-X score was not associated with EQ-5D-3L scores. Conclusion: Patients experienced PTG after surgery, and preoperative anxiety was associated with greater PTG as measured by PTGI-X. Greater PTGI-X was associated with reduced odds of analgesic use 30 days after surgery. Interventions to enhance postoperative PTG might lead to better postoperative health outcomes.