Patterns and predictors of pain following lung transplantation.

Published

Journal Article

OBJECTIVE:Our objective was to examine variability in pain levels following lung transplantation, and examine individual biopsychosocial factors influencing changes in pain. METHOD:We performed a retrospective study of a cohort of 150 patients transplanted and discharged from Duke University Hospital between January 2015 and September 2016. During hospitalization and at clinic visits up to two months after discharge, subjective pain ratings were obtained using a 0-10 Numeric Rating Scale. Psychiatric diagnoses of anxiety and depression and Center for Epidemiological Studies - Depression (CES-D) scores collected after hospital discharge were examined as predictors of post-surgery pain. Medical and surgical variables were examined as covariates. RESULTS:During hospitalization, pain ratings decreased over time (p<0.001). Predictors of higher pain levels included pre-transplant history of depression (p=0.001) and anxiety (p=0.04), bilateral lung transplant (p=0.03), and lower six-minute walk distance (p=0.02). Two months after discharge, 18% of patients reported continued pain and 34% remained on opioid pain medications. Two months after discharge, more frequent post-operative complications predicted higher pain levels in a univariate analysis (p=0.02) although this relationship was attenuated after adjustment for depression. In a multivariate analysis, elevated CES-D scores (p=0.002), and greater opioid use (p=0.031) predicted higher pain levels 2-months post-discharge. CONCLUSION:We conclude that patients with psychiatric comorbidities may be at risk for greater pain, and may require additional strategies for more effective pain management.

Full Text

Duke Authors

Cited Authors

  • Farquhar, JM; Smith, PJ; Snyder, L; Gray, AL; Reynolds, JM; Blumenthal, JA

Published Date

  • January 2018

Published In

Volume / Issue

  • 50 /

Start / End Page

  • 125 - 130

PubMed ID

  • 29190571

Pubmed Central ID

  • 29190571

Electronic International Standard Serial Number (EISSN)

  • 1873-7714

International Standard Serial Number (ISSN)

  • 0163-8343

Digital Object Identifier (DOI)

  • 10.1016/j.genhosppsych.2017.11.007

Language

  • eng