Incidence and risk factors of pain following breast cancer surgery: a retrospective national inpatient sample database study.
Humans
Female
Breast Neoplasms
/ surgery
Retrospective Studies
Middle Aged
Risk Factors
Pain, Postoperative
/ epidemiology
Incidence
Aged
Databases, Factual
United States
/ epidemiology
Adult
Inpatients
/ statistics & numerical data
Mastectomy
/ adverse effects
Length of Stay
/ statistics & numerical data
Breast cancer surgery
Comorbidities
Complications
Postoperative pain
Journal
BMC women's health
ISSN: 1472-6874
Titre abrégé: BMC Womens Health
Pays: England
ID NLM: 101088690
Informations de publication
Date de publication:
29 Oct 2024
29 Oct 2024
Historique:
received:
19
01
2024
accepted:
24
10
2024
medline:
30
10
2024
pubmed:
30
10
2024
entrez:
30
10
2024
Statut:
epublish
Résumé
Postoperative pain (PP) is a dynamic process that reflects the complex interplay between symptoms, treatment, and patient experiences, and its intensity is reportedly primarily related to the severity of surgical trauma. However, no large-scale national database-based study has hitherto been conducted to assess the occurrence and features related to PP following breast cancer (BC) surgery. In this retrospective analysis, we screened BC surgery cases between 2015 and 2019 within the National Inpatient Sample (NIS) Database, utilizing the International Classification of Diseases (ICD) 10th edition clinical modification codes. The researchers identified patients who developed PP and compared them to those who did not. Factors associated with PP were then screened: patient demographics (age and race), hospital characteristics (type of insurance, bed size, teaching status, type of admission, location, and hospital area), length of stay (LOS), total cost during hospitalization, inpatient mortality, comorbidities, and perioperative complications. Data were analyzed using descriptive statistics. Multivariate logistic regression analysis was used to determine the independent risk factors for postoperative pain in BC surgery. 39,870 BC surgery cases were identified over a five-year period from 2015 to 2019. The overall occurrence of PP following breast cancer surgery was 6.15% (2,387 cases), with a slight upward trend every year. Significant racial disparities were observed, Whites associated with a higher incidence of PP (P < 0.001). In addition, the incidence of elective admission was 11.96% lower (67.491% vs. 79.451%) than that of patients without PP following breast cancer surgery (P < 0.001). Besides, PP was related to prolonged hospitalization duration (3 vs. 2 days; P < 0.001), and higher total cost ($68,283 vs. $60,036; P < 0.001). Multivariate logistic regression identified breast cancer surgery-independent risk factors for PP, including younger age, non-elective hospital admission, rural hospitals, depression, drug abuse, metastatic cancer, psychoses, weight loss, and chronic pulmonary disease. In addition, postoperative pain for BC was associated with urinary retention, gastrointestinal complications, continuous invasive ventilation, deep vein thrombosis, urinary tract infection, blood transfusion, arrhythmia, and chest pain. Despite the low incidence of postoperative pain in BC surgery cases, it is essential to investigate factors predisposing to PP to allow optimal care management and improve the outcomes of this patient population.
Sections du résumé
BACKGROUND
BACKGROUND
Postoperative pain (PP) is a dynamic process that reflects the complex interplay between symptoms, treatment, and patient experiences, and its intensity is reportedly primarily related to the severity of surgical trauma. However, no large-scale national database-based study has hitherto been conducted to assess the occurrence and features related to PP following breast cancer (BC) surgery.
METHODS
METHODS
In this retrospective analysis, we screened BC surgery cases between 2015 and 2019 within the National Inpatient Sample (NIS) Database, utilizing the International Classification of Diseases (ICD) 10th edition clinical modification codes. The researchers identified patients who developed PP and compared them to those who did not. Factors associated with PP were then screened: patient demographics (age and race), hospital characteristics (type of insurance, bed size, teaching status, type of admission, location, and hospital area), length of stay (LOS), total cost during hospitalization, inpatient mortality, comorbidities, and perioperative complications. Data were analyzed using descriptive statistics. Multivariate logistic regression analysis was used to determine the independent risk factors for postoperative pain in BC surgery.
RESULTS
RESULTS
39,870 BC surgery cases were identified over a five-year period from 2015 to 2019. The overall occurrence of PP following breast cancer surgery was 6.15% (2,387 cases), with a slight upward trend every year. Significant racial disparities were observed, Whites associated with a higher incidence of PP (P < 0.001). In addition, the incidence of elective admission was 11.96% lower (67.491% vs. 79.451%) than that of patients without PP following breast cancer surgery (P < 0.001). Besides, PP was related to prolonged hospitalization duration (3 vs. 2 days; P < 0.001), and higher total cost ($68,283 vs. $60,036; P < 0.001). Multivariate logistic regression identified breast cancer surgery-independent risk factors for PP, including younger age, non-elective hospital admission, rural hospitals, depression, drug abuse, metastatic cancer, psychoses, weight loss, and chronic pulmonary disease. In addition, postoperative pain for BC was associated with urinary retention, gastrointestinal complications, continuous invasive ventilation, deep vein thrombosis, urinary tract infection, blood transfusion, arrhythmia, and chest pain.
CONCLUSION
CONCLUSIONS
Despite the low incidence of postoperative pain in BC surgery cases, it is essential to investigate factors predisposing to PP to allow optimal care management and improve the outcomes of this patient population.
Identifiants
pubmed: 39472876
doi: 10.1186/s12905-024-03430-3
pii: 10.1186/s12905-024-03430-3
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
583Subventions
Organisme : The Natural Science Foundation of Gansu Province
ID : 23JRRA1633
Informations de copyright
© 2024. The Author(s).
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