Pediatric chronic pain, particularly chronic postsurgical pain (CPSP), poses a significant public health challenge, impacting 20% of pediatric populations. While several presurgical predictors have been identified, there is a scarcity of data on long-term outcomes, especially beyond 1 to 2 years postsurgery. Previous research primarily focuses on North American children, creating gaps in understanding CPSP outcomes in diverse health systems, such as in Spain. This study, registered as NCT04735211, investigates CPSP in 159 children and adolescents (mean age = 12.4 years, 37.1% girls, retention rate = 65%) undergoing various surgeries in Spain. The objectives include examining CPSP prevalence (Numerical Rating Scale ≥ 4) at 3, 6, 12, and 24 months, exploring postsurgical pain trajectories through group-based trajectory modeling, and identifying potential presurgical predictors for CPSP (pain intensity, pain catastrophizing, pain anxiety, fear of pain, kinesiophobia, health-related quality of life, pain interference, and physical activity), using multiple logistic regressions. Results show a CPSP prevalence of 41% at 3 months, decreasing to 14% at 24 months. Presurgical factors including pain intensity (adjusted odds ratio [aOR] = 1.25, 95% confidence interval [CI] = 1.02-1.53), pain catastrophizing (aOR = 1.06, 95% CI = 1.00-1.13), and pain anxiety (aOR = 1.06, 95% CI = 1.02-1.11) were associated with CPSP at 3 months. Group-based trajectory modeling revealed 3 postsurgical pain trajectories: Low Pain with Rapid Recovery Group (30.2%), Moderate Pain with Recovery Group (53.5%), and High Pain with Slow Recovery Group (16.3%), with group differences in presurgical predictors, excluding physical activity. This study contributes valuable insights into CPSP, emphasizing the need for long-term follow-up. The findings could inform the implementation of preventive programs for CPSP into diverse health systems.

中文翻译：

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西班牙儿科样本中慢性术后疼痛的患病率、疼痛轨迹和术前预测因子，随访 24 个月。


儿科慢性疼痛，尤其是慢性术后疼痛 （CPSP），构成了重大的公共卫生挑战，影响了 20% 的儿科人群。虽然已经确定了几个术前预测因素，但缺乏关于长期结果的数据，尤其是术后 1 至 2 年以上。以前的研究主要集中在北美儿童身上，这在理解不同卫生系统（例如西班牙）的 CPSP 结果方面造成了差距。这项研究注册为 NCT04735211，调查了 159 名在西班牙接受各种手术的儿童和青少年 （平均年龄 = 12.4 岁，37.1% 女孩，保留率 = 65%） 的 CPSP。目标包括检查 3、6、12 和 24 个月的 CPSP 患病率（数字评定量表 ≥ 4），通过基于组的轨迹模型探索术后疼痛轨迹，并确定 CPSP 的潜在术前预测因子（疼痛强度、疼痛灾难化、疼痛焦虑、对疼痛的恐惧、运动恐惧症、与健康相关的生活质量、疼痛干扰和身体活动），使用多元 logistic 回归。结果显示 3 个月时 CPSP 患病率为 41%，24 个月时降至 14%。术前因素包括疼痛强度 （校正比值比 [aOR] = 1.25,95% 置信区间 [CI] = 1.02-1.53）、疼痛灾难化 （aOR = 1.06,95% CI = 1.00-1.13） 和疼痛焦虑 （aOR = 1.06,95% CI = 1.02-1.11） 与 3 个月时的 CPSP 相关。基于组的轨迹模型揭示了 3 个术后疼痛轨迹：低痛伴快速恢复组 （30.2%）、中度疼痛伴恢复组 （53.5%） 和高痛伴慢恢复组 （16.3%），术前预测因子存在组别差异，不包括体力活动。 本研究为 CPSP 提供了有价值的见解，强调了长期随访的必要性。这些发现可以为在不同的卫生系统中实施 CPSP 预防计划提供信息。