Factors Associated With the Development of Chronic Post-Sternotomy Pain: a Case-Control Study

• Main Authors: Mário Augusto Cray da Costa, Conrado Auer Trentini, Marcelo Derbli Schafranski, Oswaldo Pipino, Ricardo Zanetti Gomes, Elise Souza dos Santos Reis
• Format: Article
• Language: English
• Published: Sociedade Brasileira de Cirurgia Cardiovascular 2015-10-01
• Series: Brazilian Journal of Cardiovascular Surgery
• Subjects: Chronic Pain; Cardiac Surgical Procedures; Sternotomy
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0102-76382015000500552&lng=en&tlng=en

ABSTRACT OBJECTIVE: The aim of the present study was to investigate the factors associated with chronic post-sternotomy pain in heart surgery patients. METHODS: Between January 2013 and February 2014, we evaluated 453 patients with >6 months post-sternotomy for cardiac surgery at a surgical outpatient clinic. The patients were allocated into a group with chronic post-sternotomy pain (n=178) and a control group without pain (n=275). The groups were compared for potential predictors of chronic post-sternotomy pain. We used Cox proportional hazards regression to determine which independent variables were associated with the development of chronic post-sternotomy pain. RESULTS: In total, 39.29% of the patients had chronic poststernotomy pain. The following factors were significantly associated with chronic post-sternotomy pain: (a) use of the internal thoracic artery in coronary bypass grafting (P =0.009; HR=1.39; 95% CI, 1.08 to 1.80); (b) a history of antidepressant use (P =0.0001; HR=2.40; 95% CI, 1.74 to 3.32); (c) hypothyroidism (P =0.01; HR=1.27; 95% CI, 1.03 to 1.56); (d) surgical wound complication (P =0.01; HR=1.69; 95% CI, 1.08 to 2.63), and (e) patients on disability benefits or scheduled for a consultative medical examination for retirement (P =0.0002; HR=2.05; 95% CI, 1.40 to 3.02). CONCLUSION: The factors associated with chronic poststernotomy pain were: use of the internal thoracic artery; use of antidepressants; hypothyroidism; surgical wound complication, and patients on disability benefits or scheduled for a consultative examination.