Janssen et al reported 2 rules for prediction of severe postoperative pain, one for outpatient and one for inpatient surgery. These were based on the clinical prediction rule of Kalman et al (second author). The authors are from University Medical Center Utrecht and Academic Medical Center Amsterdam in The Netherlands.
Patient selection: undergoing outpatient surgery
Parameters:
(1) sex
(2) age in years
(3) pre-operative numeric pain score, from 0 to 10
(4) incision size in cm
(5) amount of pain for type of surgery
(6) Amsterdam Preoperative Anxiety and Information Scale (APAIS subscore) for anxiety, from 4 to 20
(7) APAIS subscore for need for information, from 2 to 10
|
Parameter |
Finding |
Points |
|
sex |
male |
0 |
|
|
female |
3 |
|
age in years |
< 35 years |
-1 |
|
|
35 to 57 |
-2 |
|
|
58 to 79 |
-3 |
|
|
>= 80 |
-4 |
|
pre-operative pain |
0 |
0 |
|
|
1 or 2 |
1 |
|
|
3 or 4 |
2 |
|
|
5 or 6 |
3 |
|
|
7 or 8 |
4 |
|
|
9 |
5 |
|
|
10 |
6 |
|
incision size |
< 10 cm |
0 |
|
|
>= 10 cm |
2 |
|
pain level for surgery |
lowest pain |
0 |
|
|
low pain |
2 |
|
|
moderate pain |
2 |
|
|
high pain |
5 |
|
|
highest pain |
1 (?? 10??) |
|
pre-operative anxiety |
4, 5, or 6 |
1 |
|
|
7 to 10 |
2 |
|
|
11 to 14 |
3 |
|
|
15 to 18 |
4 |
|
|
19 or 20 |
5 |
|
pre-operative need for information |
2 to 5 |
-1 |
|
|
6 to 9 |
-2 |
|
|
10 |
-3 |
total score =
= SUM(points for all of the points) + (constant)
|
Incidence of Severe Postoperative Pain in the Population |
Constant |
|
60% |
-4 |
|
55% |
-6 |
|
50% |
-7 |
|
45% |
-8 |
|
40% |
-9 |
|
35% |
-10 |
|
30% |
-11 |
|
25% |
-12 |
|
20% |
-15 |
|
Total Score |
Risk of Severe Pain |
|
<= -8 |
19% |
|
-7 |
22% |
|
-6 |
25% |
|
-5 |
29% |
|
-4 |
30% |
|
-3 |
31% |
|
-2 |
33% |
|
-1 |
37% |
|
0 |
42% |
|
1 |
49% |
|
2 |
52% |
|
3 |
57% |
|
4 |
61% |
|
5 |
67% |
|
6 |
70% |
|
7 |
74% |
|
8 |
77% |
|
9 |
81% |
|
10 |
83% |
|
11 |
84% |
|
12 |
87% |
Specialty: Anesthesiology
