Risk factors for persistent postsurgical pain in women undergoing hysterectomy due to benign causes: a prospective predictive study

Abstract

Persistent postsurgical pain (PPSP) is a major clinical problem with significant individual, social, and healthcare costs. The aim of this study was to examine the role of demographic, clinical and psychological risk factors in the development of persistent postsurgical pain (PPSP) after hysterectomy due to benign disorders. In a prospective study, a consecutive sample of 186 women was assessed 24 hours before (T1), 48 hours (T2), and 4 months (T3) after surgery. Regression analyses were performed to identify predictors of PPSP. Four months after hysterectomy, 93 (50%) participants reported experiencing pain (NRS >0). Age, pain due to other causes, and type of hysterectomy emerged as significant predictive factors. Baseline presurgical psychological predictors identified were anxiety, emotional representation of the condition leading to surgery, and pain catastrophizing. Among the identified psychological predictors, emotional representation emerged as the strongest. Acute postsurgical pain frequency and postsurgical anxiety also revealed a predictive role in PPSP development. These results increase the knowledge on PPSP predictors and point healthcare professionals towards specific intervention targets such as anxiety (pre- and postsurgical), pain catastrophizing, emotional representations, and acute pain control after surgery.