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The Association Between Pain and In-Hospital Complications and Duration of Stay After Colorectal Surgery

  • Author Footnotes
    a N.A. and B.B.-A. have contributed equally to this study and should be considered as equal first authors.
    Noga Avrahami
    Footnotes
    a N.A. and B.B.-A. have contributed equally to this study and should be considered as equal first authors.
    Affiliations
    Recanati School for Community Health Professions, Department of Nursing, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel and Soroka University Medical Center, Beer-Sheva, Israel

    High Risk Pregnancy Department, Baruch Padeh Medical Center, Poriya, Tiberias, Israel
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  • Author Footnotes
    a N.A. and B.B.-A. have contributed equally to this study and should be considered as equal first authors.
    Batya Betesh-Abay
    Footnotes
    a N.A. and B.B.-A. have contributed equally to this study and should be considered as equal first authors.
    Affiliations
    Recanati School for Community Health Professions, Department of Nursing, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel and Soroka University Medical Center, Beer-Sheva, Israel
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  • Abed N. Azab
    Affiliations
    Recanati School for Community Health Professions, Department of Nursing, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel and Soroka University Medical Center, Beer-Sheva, Israel

    Department of Clinical Biochemistry and Pharmacology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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  • Tatiana Nisimov
    Affiliations
    Division of Surgery, Soroka University Medical Center, Beer-Sheva, Israel
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  • Muhammad Abu Tailakh
    Correspondence
    Address correspondence to Muhammad Abu Tailakh, R.N., M.P.H., Ph.D., Recanati School for Community Health Professions, Department of Nursing, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel and Soroka University Medical Center, Beer-Sheva, Israel, P.O. box 653, Beer-Sheva 8410501 Israel.
    Affiliations
    Recanati School for Community Health Professions, Department of Nursing, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel and Soroka University Medical Center, Beer-Sheva, Israel
    Search for articles by this author
  • Author Footnotes
    a N.A. and B.B.-A. have contributed equally to this study and should be considered as equal first authors.
Published:February 06, 2022DOI:https://doi.org/10.1016/j.pmn.2022.01.002

      Abstract

      Background

      Pain is a subjective and multidimensional experience often inadequately managed following surgery. Postoperative pain has been shown to correlate with hospital length of stay (HLOS) and hospital complications. Given advancements in preemptive pain management approaches, reevaluation is necessary.

      Aims

      The purpose of this study was to examine the association between postoperative pain intensity and HLOS and in-hospital complications among patients who underwent colorectal surgery, adjusted by sociodemographic and underlying medical variables.

      Setting and Patients

      We used electronic medical records. Data were collected from patients who underwent colorectal surgery at a large general hospital in Israel from January 2012 to December 2018.

      Design and Methods

      This is a retrospective cohort study. Information on HLOS, medical diagnoses, pain intensity, use of analgesics, postoperative infections, patient sociodemographic data, chronic diseases, functionality status, and source of admission were extracted from medical records. Logistic regression analysis was used for the final model, and HLOS and in-hospital complications were the major outcomes.

      Results

      We enrolled 1,073 patients. Of them, 554 males (51.6%) with a mean age of 62.54 ± 16.55 years. The median postoperative pain score was 1.54 (interquartile range, 0.84; 2.16), and an in-hospital complication rate of 1.3% (n = 14). Postoperative pain was not associated with prolonged HLOS with adjustment to relevant independent variables (odds ratio, 1.399; 95% confidence interval, 0.759-2.578; p = .282). Contrarily, age, malignancy, assistance needed in activities of daily living, use of analgesic agents, and postoperative infection were risk factors for prolonged HLOS. Additionally, postoperative pain was not related to a higher risk of in-hospital complications.

      Conclusions

      Pain intensity post colorectal surgery was not a risk factor for extended HLOS or in-hospital complications. In contradistinction, tending to patient needs, adequate analgesic use, and reducing infection rates can shorten HLOS, improve health outcomes, and economize health care resources.

      Keywords

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