The Connection Between Postoperative Pain and Complications
In a recent report, van Boekel and colleagues[1] provide helpful information to clarify this relationship. Their retrospective study included all patients (N = 1014) who underwent different types of surgery in a Dutch hospital from 2012 to 2015, with general surgery, orthopedics, and urology comprising the major subgroups.
The authors reviewed complications (overall complication rate, 34%) and patient-reported pain levels and found that the risk for complications increased as pain levels rose. Compared with patients who reported the lowest level of pain, patients with moderate pain had about a two-fold greater risk for complications (P = .005), and patients reporting the highest level of pain had a nearly threefold greater risk for complications (P < .001). The pain-complication link was generally similar in the various surgical subgroups.
How do these results compare with previous studies? A report based on 211,231 operations performed on patients in the US Veterans Administration system found postoperative pain to be a strong factor leading to readmission and unplanned visits to the emergency departments.[2]
In another, highly cited study of 411 older patients treated for hip fracturethe authors concluded that improved pain control could shorten hospital length of stay and perhaps improve overall functional results.
