Chronic Post-thoracotomy Pain and Health-Related Quality of Life

The information provided here supplements an article to be published in the Annals of Thoracic Surgery, "Chronic Post-thoracotomy Pain and Health-Related Quality of Life" (In press, expected publication 2012).

Authors

Michelle A. O. Kinney, M.D., W. Michael Hooten, M.D., Stephen D. Cassivi, M.D., M.Sc., Mark S. Allen, M.D., Melissa A. Passe, R.R.T., Andrew C. Hanson, B.S., Darrell R. Schroeder, M.S., Carlos B. Mantilla, M.D., Ph.D.

Supported by Grant Number 1 UL1 RR024150 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH), and the NIH Roadmap for Medical Research.

Abstract

Background

Pain following thoracotomy is common. The objective of this study was to assess whether pain 3 months post-thoracotomy negatively impacts quality of life.

Methods

One hundred and ten patients were prospectively assessed using the Short Form-36 (SF-36) Health Survey before and 3 months after elective thoracotomy. Pain and medication use were also evaluated 3 months postoperatively by questionnaire. Patients experiencing pain at 3 months post-thoracotomy were compared with patients who did not have post-thoracotomy pain.

Results

Seventy-five patients (68%) had pain at 3 months post-thoracotomy, but only 12 patients (11%) rated their average pain in the previous week greater than 3 on the 0-10 numeric rating scale, and only 18 (16%) required opioid analgesics. Fifty-seven patients (77%) reported improvement in their pain with time. There were significant differences between patients who had post-thoracotomy pain at 3 months versus those who did not in specific SF-36 subscales. The pain group reported lower SF-36 scores in: physical functioning (P=0.049), bodily pain (P=0.0002), and vitality (P=0.044). There were no significant differences in the general health, role physical, social functioning, role emotional, and mental health index subscales of the SF-36 survey between the pain and non-pain groups.

Conclusion

In this prospective evaluation of patients following elective thoracotomy, pain is commonly reported at 3 months, but is generally mild, shows improvement over with time, and does not usually require opioid analgesics. Patients who experience post-thoracotomy pain at 3 months are at risk for significantly decreased physical functioning and vitality, but are not at risk for significantly decreased social, emotional, or mental health functioning compared with patients who do not experience post-thoracotomy pain at 3 months.

Supplemental appendix cited in the article

For more information, please contact the corresponding author:
Michelle A. O. Kinney, M.D.
200 1st St. SW
Rochester, MN
Phone: 507-266-9877
Fax: 507-284-0120
kinney.michelle@mayo.edu