Bone and Joint Institute


Examination of psychological risk factors for chronic pain following cardiac surgery: protocol for a prospective observational study


Michael H. McGillion, McMaster University
Shaunattonie Henry, McMaster University
Jason W. Busse, McMaster University
Carley Ouellette, McMaster University
Joel Katz, York University
Manon Choinière, Centre Hospitalier de L'Universite de Montreal
Andre Lamy, Population Health Research Institute, Ontario
Richard Whitlock, Population Health Research Institute, Ontario
Shirley Pettit, Population Health Research Institute, Ontario
Jacqueline Hare, Population Health Research Institute, Ontario
Krysten Gregus, Population Health Research Institute, Ontario
Katheryn Brady, Population Health Research Institute, Ontario
Nazari Dvirnik, Population Health Research Institute, Ontario
Stephen Su Yang, Population Health Research Institute, Ontario
Joel Parlow, Queen's University, Kingston
Deborah Dumerton-Shore, Kingston General Hospital
Ian Gilron, Queen's University, Kingston
D. Norman Buckley, McMaster University
Harsha Shanthanna, McMaster University
Sandra L. Carroll, McMaster University
Peter C. Coyte, University of Toronto
Shanil Ebrahim, McMaster University
Wanrudee Isaranuwatchai, University of Toronto
Denise N. Guerriere, University of Toronto
Jeffrey Hoch, University of California, Davis
James Khan, McMaster University
Joy MacDermid, Western University
Geraldine Martorella, Florida State University
J. Charles Victor, University of Toronto
Judy Watt-Watson, University of Toronto
Kimberly Howard-Quijano, David Geffen School of Medicine at UCLA
Aman Mahajan, David Geffen School of Medicine at UCLA
Matthew T.V. Chan, Chinese University of Hong Kong

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BMJ open





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© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. INTRODUCTION: Approximately 400 000 Americans and 36 000 Canadians undergo cardiac surgery annually, and up to 56% will develop chronic postsurgical pain (CPSP). The primary aim of this study is to explore the association of pain-related beliefs and gender-based pain expectations on the development of CPSP. Secondary goals are to: (A) explore risk factors for poor functional status and patient-level cost of illness from a societal perspective up to 12 months following cardiac surgery; and (B) determine the impact of CPSP on quality-adjusted life years (QALYs) borne by cardiac surgery, in addition to the incremental cost for one additional QALY gained, among those who develop CPSP compared with those who do not. METHODS AND ANALYSES: In this prospective cohort study, 1250 adults undergoing cardiac surgery, including coronary artery bypass grafting and open-heart procedures, will be recruited over a 3-year period. Putative risk factors for CPSP will be captured prior to surgery, at postoperative day 3 (in hospital) and day 30 (at home). Outcome data will be collected via telephone interview at 6-month and 12-month follow-up. We will employ generalised estimating equations to model the primary (CPSP) and secondary outcomes (function and cost) while adjusting for prespecified model covariates. QALYs will be estimated by converting data from the Short Form-12 (version 2) to a utility score. ETHICS AND DISSEMINATION: This protocol has been approved by the responsible bodies at each of the hospital sites, and study enrolment began May 2015. We will disseminate our results through CardiacPain.Net, a web-based knowledge dissemination platform, presentation at international conferences and publications in scientific journals. TRIAL REGISTRATION NUMBER: NCT01842568.

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