Prevalence and risk factors of chronic postsurgical pain after lung cancer surgery and knee arthroplasty: a prospective multicenter cohort study in Japan

Purpose: Chronic postsurgical pain (CPSP) is being increasingly recognized as an important clinical problem. The purpose of this prospective multicenter study was to evaluate the prevalence and risk factors of CPSP at 3 months after surgery in a Japanese population. Methods: Adult patients who underwent lung cancer surgery (L) or knee arthroplasty (K) at university hospitals in Japan and provided informed consent were included. Perioperative demographic, clinical, and psychological data were collected. Postsurgical pain scores were assessed via face-to-face interviews at each time point. We also investigated analgesic use at each time point in patients with CPSP. Results: A total of 494 (L) and 194 (K) patients completed our interviews at all visits up to 3 months after surgery. The prevalence of clinically relevant CPSP was 10% (L) and 28% (K), respectively. In both cohorts, pain intensity at 1 month after surgery was moderately correlated with pain intensity at 3 months after surgery. Multivariate logistic regression analysis revealed significant associations between preoperative chronic pain, current smoking status, and open thoracotomy with CPSP in the lung cohort. However, no pre- or intraoperative risk factors were identified in the knee cohort. None of the CPSP patients used strong opioids. Conclusions: The prevalence of CPSP after lung cancer surgery and knee arthroplasty among Japanese patients was comparable with prevalences previously reported in other countries. Subacute pain was significantly correlated with CPSP; however, further studies are needed to determine whether intensive treatment of subacute postsurgical pain can prevent the development of CPSP.