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Risk model predicts chronic postop pain for VHR patients



Postoperative pain that lingers for months is a common outcome of ventral hernia repair surgery. A predictive model has been developed by investigators at the Carolina Medical Center in Charlotte, N.C., to determine which hernia patients are at risk for chronic postoperative pain.

Tiffany C. Cox, MD, and the research team used the International Hernia Mesh Registry to obtain a sample of 887 ventral hernia repair patients that had surgery between 2007 and 2014. Data on postoperative pain was based on the Carolinas Comfort Scale questionnaire administered at 1, 6 and 12 months after surgery. Logistic regression analyses were used to determine independent predictors of postoperative chronic pain and a risk model was developed (Am J Surg. 2016 Sep; 212[3]:501-10).

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The average age of patients in the sample was about 57 years and slightly more than half were women. A total of 17% were active smokers, 13.2% used narcotics preoperatively, and three-quarters of the sample were available for follow-up at 1 year. Of those followed, 26% reported chronic pain. The study looked at determinants of pain at each interval and those baseline, 1-month, and 6-month predictors were incorporated into the multivariate regression model for predicting chronic pain risk at 1 year.

The investigators concluded that the statistically significant predictors of risk for developing chronic postoperative pain at 1 year were preoperative pain and pain at 1 month of 2 or greater on the Carolina Comfort Scale (odds ratio, 2.97 and 2.64, respectively), female sex (OR, 1.74), and repair of recurrent hernias (OR, 1.59).

The predictive model for chronic postoperative pain may be helpful to surgeons in counseling patients and in devising postoperative interventions.

The investigators had no disclosures.

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