TY - JOUR
T1 - Pain catastrophizing scale as a predictor for acute postoperative pain following video-assisted thoracoscopic surgery lobectomy
AU - Visby, Lasse
AU - Engdahl, Simone
AU - Secher, Erik Lilja
AU - Møller-Sørensen, Hasse
AU - Kehlet, Henrik
AU - Petersen, René Horsleben
N1 - © The Author(s) 2025. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved. For commercial re-use, please contact [email protected] for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact [email protected].
PY - 2025/6/3
Y1 - 2025/6/3
N2 - OBJECTIVES: Postoperative pain after thoracic surgery remains a significant challenge, underscoring the need to identify patients at risk of severe pain. While prior research across various surgical types highlights the Pain Catastrophizing Scale (PCS) as a key psychological predictor of acute postoperative pain, evidence specific to thoracic surgery is limited. This study aimed to investigate the association between PCS and postoperative pain in patients undergoing multiportal video-assisted thoracoscopic surgery (VATS) lobectomy.METHODS: We conducted a prospective observational study including consecutive patients scheduled for VATS lobectomy. Patients completed the PCS-questionnaire preoperatively and pain scores (Numeric Rating Scale) were collected twice daily for the first 2 postoperative days under 4 conditions: resting, coughing, using a positive expiratory pressure (PEP) device and 5-meter walk-test.RESULTS: In total, 100 patients were included. Median age was 72 [interquartile range (IQR): 64, 76] years, and 57% of patients were female. Median PCS score for all patients was 11 (IQR: 319). The minimum observed PCS score was 0, and the maximum was 43. Twenty-two (24.7%) of the patients presented with a PCS score ≥ 20 and were considered high-pain responders. High-pain responders reported significantly higher pain scores during coughing (6.00 vs 5.00, P = 0.02) and 5-meter-walk test (3.42 vs 1.75, P = 0.034) and were more likely to experience moderate-severe pain (95.5% vs 71.6%, P = 0.02) during the first 2 postoperative days. Linear regression confirmed that higher PCS scores were significantly associated with increased pain across most conditions, particularly coughing and 5-meter-walk-test.CONCLUSIONS: Higher PCS scores were associated with increased risk of acute postoperative pain following VATS lobectomy. The PCS is a simple, rapid and reliable predictor of acute postoperative pain.
AB - OBJECTIVES: Postoperative pain after thoracic surgery remains a significant challenge, underscoring the need to identify patients at risk of severe pain. While prior research across various surgical types highlights the Pain Catastrophizing Scale (PCS) as a key psychological predictor of acute postoperative pain, evidence specific to thoracic surgery is limited. This study aimed to investigate the association between PCS and postoperative pain in patients undergoing multiportal video-assisted thoracoscopic surgery (VATS) lobectomy.METHODS: We conducted a prospective observational study including consecutive patients scheduled for VATS lobectomy. Patients completed the PCS-questionnaire preoperatively and pain scores (Numeric Rating Scale) were collected twice daily for the first 2 postoperative days under 4 conditions: resting, coughing, using a positive expiratory pressure (PEP) device and 5-meter walk-test.RESULTS: In total, 100 patients were included. Median age was 72 [interquartile range (IQR): 64, 76] years, and 57% of patients were female. Median PCS score for all patients was 11 (IQR: 319). The minimum observed PCS score was 0, and the maximum was 43. Twenty-two (24.7%) of the patients presented with a PCS score ≥ 20 and were considered high-pain responders. High-pain responders reported significantly higher pain scores during coughing (6.00 vs 5.00, P = 0.02) and 5-meter-walk test (3.42 vs 1.75, P = 0.034) and were more likely to experience moderate-severe pain (95.5% vs 71.6%, P = 0.02) during the first 2 postoperative days. Linear regression confirmed that higher PCS scores were significantly associated with increased pain across most conditions, particularly coughing and 5-meter-walk-test.CONCLUSIONS: Higher PCS scores were associated with increased risk of acute postoperative pain following VATS lobectomy. The PCS is a simple, rapid and reliable predictor of acute postoperative pain.
KW - Humans
KW - Thoracic Surgery, Video-Assisted/adverse effects
KW - Female
KW - Pain, Postoperative/diagnosis
KW - Male
KW - Prospective Studies
KW - Aged
KW - Middle Aged
KW - Pneumonectomy/adverse effects
KW - Catastrophization/psychology
KW - Pain Measurement/methods
UR - http://www.scopus.com/inward/record.url?scp=105009287645&partnerID=8YFLogxK
U2 - 10.1093/ejcts/ezaf174
DO - 10.1093/ejcts/ezaf174
M3 - Journal article
C2 - 40397990
SN - 1010-7940
VL - 67
JO - European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
JF - European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
IS - 6
M1 - ezaf174
ER -