Format

Send to

Choose Destination
BMJ Open. 2019 Mar 1;9(2):e022995. doi: 10.1136/bmjopen-2018-022995.

Examination of psychological risk factors for chronic pain following cardiac surgery: protocol for a prospective observational study.

Author information

1
School of Nursing, McMaster University, Faculty of Health Sciences, Hamilton, Ontario, Canada.
2
Anesthesiology, Perioperative Medicine and Surgical Research Unit, Population Health Research Institute, Hamilton, Ontario, Canada.
3
Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada.
4
Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada.
5
Department of Psychology, York University, Toronto, Ontario, Canada.
6
Centre de recherche de Centre hospitalier de l'Université de Montreal, Montreal, Quebec, Canada.
7
Department of Anesthesiology and Perioperative Medicine, Queen's University, Kingston, Ontario, Canada.
8
Department of Anesthesiology, Kingston General Hospital, Kingston, Ontario, Canada.
9
Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
10
Department of Public Health Sciences, University of California, Davis, Davis, California, USA.
11
School of Physical Therapy, Western University, London, Ontario, Canada.
12
College of Nursing, Florida State University, Tallahassee, Florida, USA.
13
Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.
14
Department of Anesthesiology, David Geffen School of Medicine at University of California, Los Angeles, California, USA.
15
Department of Anesthesia and Intensive Care, The Chinese University of Hong Kong, Shatin, Hong Kong.
16
Department of Anesthesia, University of Toronto, Toronto, Ontario, Canada.

Abstract

INTRODUCTION:

Approximately 400 000 Americans and 36 000 Canadians undergo cardiac surgery annually, and up to 56% will develop chronic postsurgical pain (CPSP). The primary aim of this study is to explore the association of pain-related beliefs and gender-based pain expectations on the development of CPSP. Secondary goals are to: (A) explore risk factors for poor functional status and patient-level cost of illness from a societal perspective up to 12 months following cardiac surgery; and (B) determine the impact of CPSP on quality-adjusted life years (QALYs) borne by cardiac surgery, in addition to the incremental cost for one additional QALY gained, among those who develop CPSP compared with those who do not.

METHODS AND ANALYSES:

In this prospective cohort study, 1250 adults undergoing cardiac surgery, including coronary artery bypass grafting and open-heart procedures, will be recruited over a 3-year period. Putative risk factors for CPSP will be captured prior to surgery, at postoperative day 3 (in hospital) and day 30 (at home). Outcome data will be collected via telephone interview at 6-month and 12-month follow-up. We will employ generalised estimating equations to model the primary (CPSP) and secondary outcomes (function and cost) while adjusting for prespecified model covariates. QALYs will be estimated by converting data from the Short Form-12 (version 2) to a utility score.

ETHICS AND DISSEMINATION:

This protocol has been approved by the responsible bodies at each of the hospital sites, and study enrolment began May 2015. We will disseminate our results through CardiacPain.Net, a web-based knowledge dissemination platform, presentation at international conferences and publications in scientific journals.

TRIAL REGISTRATION NUMBER:

NCT01842568.

KEYWORDS:

cardiac surgery; health economics; pain management

PMID:
30826789
DOI:
10.1136/bmjopen-2018-022995
Free PMC Article

Conflict of interest statement

Competing interests: M­­­­HM and PJD are members of a research group with a policy of not accepting honorariums or other payments from industry for their own personal financial gain. They do accept honorariums/payments from industry to support research endeavours and costs to participate in meetings. Based on study questions, PJD has originated and grants he has written, he has received grants from Abbott Diagnostics, Boehringer Ingelheim, Covidien, Octapharma, Philips Healthcare, Roche Diagnostics and Stryker. PJD has participated in an consultancy advisory board meeting for Boehringer Ingelheim.

Supplemental Content

Full text links

Icon for HighWire Icon for PubMed Central
Loading ...
Support Center