Real-world data on patient-reported outcomes and potential factors associated with pain after thyroid/parathyroid surgery: a prospective QUIPS registry analysis of a large cohort - sparking new pain management concepts.

Abstract

Background: Although thyroid and parathyroid surgeries are common elective procedures in Germany, postoperative pain management remains unstandardized. This prospective study sought to quantify postoperative pain intensity after thyroid and parathyroid surgery and to examine factors associated with postoperative pain.

Methods: We prospectively enrolled 217 adult inpatients undergoing non-oncologic thyroid or parathyroid surgery between September 2021 and September 2022 into the QUIPS (Quality Improvement in Postoperative Pain Management) registry. On postoperative day one (POD1), patient-reported outcomes were assessed using the standardized QUIPS questionnaire, including an 11-point numeric rating scale (NRS) ranging from 0 to 10. Demographic, perioperative, and treatment-related variables were summarized descriptively, and associations with postoperative outcomes were examined using univariable, unadjusted group comparisons.

Results: Postoperative pain was reported by 96.8% of the patients, with a mean maximum NRS score of 4.89 ± 2.76 and a mean pain-on-exertion score of 3.88 ± 2.32. In the univariable, unadjusted analyses, higher maximum pain scores were observed among women, patients younger than 65 years, patients with pre-existing chronic pain, and patients classified as ASA I. Maximum pain scores differed according to the type of surgery and were highest after total thyroidectomy. Pain on exertion and pain-related mood impairment also differed across operative-duration groups, with the highest values observed after procedures lasting 121-180 min. Individualized preoperative information on postoperative pain management was associated with higher patient satisfaction and a lower reported desire for additional analgesia.

Conclusion: Moderate pain was frequently reported after thyroid and parathyroid surgery, with pain intensity varying according to patient- and procedure-related characteristics in unadjusted analyses. Our findings support the implementation of standardized approaches to postoperative pain management and preoperative patient education.