关键词: 胸腔镜手术, 慢性术后疼痛, 危险因素, 预测模型

Abstract: Objective To construct a prognostic prediction model for chronic postsurgical pain after video-assisted thoracoscopic surgery and develop a risk evaluation tool. Methods As a single-center prospective study, the study enrolled 1 132 patients received video-assisted thoracoscopic surgery between November 2020 and May 2021 at Peking Union Medical College Hospital. Numeric rating scale was used to assess the severity of acute pain when they were discharged and chronic pain at 6 months after surgery. Patients were divided into two groups based on the presence or absence of chronic postsurgical pain. Multivariate Logistic regression was conducted to analyze the risk factors which were used to construct prediction model and draw nomogram for chronic postsurgical pain after video-assisted thoracoscopic surgery. Results 460 patients (40.6%) were reported chronic pain at 6 months after surgery. More women and more patients with coronary heart disease belonged to the group of chronic postsurgical pain. Patients reported higher scores of numeric rating scale when they were discharged and inclined to keep taking painkiller after discharge. However, there were fewer patients with incisions fewer than 3 or using nitrous oxide during surgery in the group of chronic postsurgical pain (P＜0.05). The outcome of multivariate Logistic regression showed that the history of coronary heart disease, not using nitrous oxide in surgery, incisions more than or equal to 3, and the score of numeric rating scale on discharge were independent risk factors for chronic postsurgical pain (P＜0.05). The area under the receiver operator characteristic curve of the prediction model was 0.734. Conclusions The prediction model is conducive to clinical management for chronic postsurgical pain after video-assisted thoracoscopic surgery.

Key words: video-assisted thoracoscopic surgery, chronic postsurgical pain, risk factors, prediction model