Analysis of the influencing factors of postoperative chronic pain in patients with lung cancer undergoing thoracoscopic radical surgery and construction of the predictive model

ZENG Xiuping

Abstract：Objective:To investigate and analyze the influencing factors of chronic pain after thoracoscopic radical resection of lung cancer and build a predictive model.Methods:All 148 patients with non-small cell lung cancer(NSCLC)who underwent thoracoscopic radical resection of lung cancer in our hospital from March 2021 to March 2022 were selected.The patients'postoperative incision pain was scored with numerical grading score(NRS),and the NRS score of more than 3 months after surgery was more than 3 points as chronic pain.56 patients with postoperative chron-ic pain were treated as pain group,and the remaining 92 patients were treated as pain free group.Single factor and multi factor regression analysis was conducted on the factors that may affect the occurrence of postoperative chronic pain,and a prediction model of postoperative chronic pain was established.Results:Among 148 patients,56 patients still had pain at the incision 3 months after operation,and the incidence of chronic pain was 37.84％.The results of single factor com-parison showed that there were significant differences between the pain group and the pain free group in terms of post-operative radiotherapy,postoperative chemotherapy,operation time,the highest NRS score 2 days after operation,and the NRS score of the first outpatient follow-up 14 days after operation(P＞0.05).The factors with statistical signifi-cance in the above univariate analysis were used as independent variables,and the groups were used as dependent varia-bles for stepwise regression analysis.The results showed that the NRS score of the first outpatient follow-up 14 days after surgery,the operation time,the highest NRS score 2 days after surgery,and postoperative radiotherapy entered the regression model(P＜0.05).Prediction model formula:Logit(P)=-0.913+0.140 × postoperative radiotherapy+0.006 X operation time+0.054 × highest NRS score 2 days after operation+0.267 X NRS score of the first outpatient fol-low-up 14 days after operation.With the increase of Logit(P)value,the risk of chronic pain after operation increases.Conclusion:The NRS score of the first outpatient follow-up 14 days after operation,the operation time,the highest NRS score 2 days after operation,and postoperative radiotherapy are independent risk factors that affect the occurrence of postoperative chronic pain in patients undergoing thoracoscopic radical resection of lung cancer.A predictive model of postoperative chronic pain is established to provide basis for clinical nursing of chronic pain.