膝关节置换术后慢性疼痛的相关因素和风险预测。

IF 0.9 4区 医学 Q3 SURGERY
Jun Yang, Hui Gao, Canbin Wang, Jiangjun Zhou
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引用次数: 0

摘要

目的:本研究旨在探讨与全膝关节置换术(TKA)后慢性疼痛相关的潜在风险因素,并建立术后慢性疼痛(CPSP)的风险预测模型:本研究回顾性分析了2021年1月至2024年1月期间在我院接受TKA手术的160例患者的临床数据。基线特征、既往病史、CPSP情况和疼痛数字评分量表(NRS)等相关数据均来自医疗信息系统。对影响患者术后 CPSP 的风险因素进行了逻辑回归分析。结果:160名患者中,67人(41.88%)在手术切口处或周围出现CPSP。在术前和术后 3 个月的运动中,CPSP 组的 NRS 疼痛评分明显高于非 CPSP 组。此外,术后 3 个月休息时,CPSP 组的 NRS 评分也高于非 CPSP 组(P < 0.05)。我们观察到,术前 NRS 评分、术前特殊手术医院(HSS)评分、术后功能训练和术后不良事件是影响 TKA 术后 CPSP 发生的独立因素(P < 0.05)。此外,术前 NRS 评分、术后不良事件与 CPSP 疼痛严重程度呈显著正相关,而术前 HSS 评分、术后功能训练与 CPSP 疼痛严重程度呈显著负相关(P < 0.05)。TKA术后CPSP预测模型的接受者操作特征曲线(ROC)具有良好的校准和预测能力,曲线下面积(AUC)为0.868(95% CI:0.811-0.925):本研究初步构建了TKA术后患者CPSP风险预测模型,可帮助医务人员对术后患者的CPSP风险进行个体化预测,从而预防CPSP的发生。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Related Factors and Risk Prediction of Chronic Pain after Knee Replacement.

Aim: This study aimed to explore potential risk factors associated with chronic pain after total knee arthroplasty (TKA) and to establish the risk prediction model of chronic postoperative pain (CPSP).

Methods: This study retrospectively analyzed the clinical data of 160 patients who underwent TKA in our hospital between January 2021 and January 2024. Relevant data such as the baseline characteristics, past medical history, CPSP condition, and pain numerical rating scale (NRS) were retrieved from the medical information system. Logistic regression analysis was performed on the risk factors affecting the postoperative CPSP of the patients. The identified risk factors were incorporated to develop a risk-prediction model.

Results: Among the 160 patients, 67 (41.88%) had CPSP at or around the operation incision. The NRS pain score was significantly higher in the CPSP group than in the non-CPSP group during exercise preoperative and 3 months post-operation. Furthermore, the CPSP group had a higher NRS score than the non-CPSP group at rest 3 months after the procedure (p < 0.05). We observed that the preoperative NRS score, preoperative hospital for special surgery (HSS) score, postoperative functional training, and postoperative adverse events were the independent factors influencing the occurrence of CPSP after TKA (p < 0.05). Additionally, there was a significant positive correlation between preoperative NRS score, postoperative adverse events, and CPSP pain severity, and a significant negative correlation between preoperative HSS score, postoperative functional training, and CPSP pain severity (p < 0.05). The receiver operating characteristic (ROC) curve had excellent calibration and prediction capabilities for the predictive model of CPSP after TKA, with the area under the curve (AUC) of 0.868 (95% CI: 0.811-0.925).

Conclusions: In this study, the predictive model of CPSP risk for patients after TKA surgery was initially constructed, which can help medical staff predict the risk of CPSP in patients after surgery individually, thereby preventing the occurrence of CPSP.

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来源期刊
CiteScore
0.90
自引率
12.50%
发文量
116
审稿时长
>12 weeks
期刊介绍: Annali Italiani di Chirurgia is a bimonthly journal and covers all aspects of surgery:elective, emergency and experimental surgery, as well as problems involving technology, teaching, organization and forensic medicine. The articles are published in Italian or English, though English is preferred because it facilitates the international diffusion of the journal (v.Guidelines for Authors and Norme per gli Autori). The articles published are divided into three main sections:editorials, original articles, and case reports and innovations.
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