Key result
Female sex was associated with a significantly higher incidence of chronic postoperative pain with activity 3 months after thoracic surgery compared to male sex (35.0% vs 28.4%, adjusted OR 1.351).
Why the study?
The effect of sex and age on chronic post-thoracic surgical pain at rest and with activity remained unclear.
Does female sex increase the incidence of chronic postoperative pain in adult patients undergoing elective thoracic surgery?
Cohort (n=3,159)
No
Does female sex increase the incidence of chronic postoperative pain in adult patients undergoing elective thoracic surgery?
Odds Ratio: 1.351 (95% CI 1.104–1.652)
Absolute Event Rate: 35% vs 28.4%
p-value: p=0.003
Female sex, particularly between ages 45-55, is associated with a significantly higher incidence of chronic postoperative pain with activity 3 months after thoracic surgery.
Women may have higher CPTP incidence with activity after thoracic surgery, especially ages 45-55; hypothesis-generating and requires prospective confirmation before guiding practice.
Background The effect of sex and age on chronic post-thoracic surgical pain (CPTP) at rest and with activity remains unclear. The main purpose of this study was to investigate the relationship between the incidence of chronic postoperative pain (at rest and with activity) and sex/age differences. Methods This was a single-center retrospective study that included adult patients who had undergone elective thoracic surgery. Patients were divided into two groups based on sex. Demographic and perioperative data were collected, including age, sex, education level, Body Mass Index (BMI), American Society of Anesthesiologists (ASA) physical status, and medical history (hypertension, diabetes mellitus). Chronic postoperative pain data were collected by telephone follow-up. Results Among the 3,159 patients enrolled, 1,762 were male, and 1,397 were female. After creating a matched-pairs cohort, 1,856 patients were analyzed. The incidence of CPTP at rest was 14.9% among males and 17.8% among females ( p = 0.090). The incidence of CPTP with activity was 28.4% among males and 35.0% among females ( p = 0.002). We analyzed three different models after propensity matching to validate the stability of the prediction model between sex and CPTP, and female sex was a significant predictor of CPTP with activity 3 months after surgery. Further analysis showed that females in the 45-55-year-old age group were more prone to develop CPTP. Conclusion Females have a higher incidence of chronic postoperative pain with activity after thoracic surgery. Females in the 45-55-year-old age group are more prone to develop CPTP than females in other age groups.
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Zhao et al. (2023) conducted a cohort in Chronic post-thoracic surgical pain (CPTP) (n=3,159). Female sex vs. Male sex was evaluated on Incidence of chronic post-thoracic surgical pain (CPTP) with activity at 3 months (OR 1.351, 95% CI 1.104-1.652, p=0.003). Female sex was associated with a significantly higher incidence of chronic postoperative pain with activity 3 months after thoracic surgery compared to male sex (35.0% vs 28.4%, adjusted OR 1.351).
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