The Impact of Early PostOperative Pain on Health‐Related Quality of Life

Abstract Objectives To examine how the severity of postoperative pain affects patient's health‐related quality of life ( HRQ oL) at 1 week following surgery and to compare two generic validated HRQ o L instruments. Methods Patients undergoing general or orthopaedic surgery at the R oyal L ondon H ospital were randomly sampled. The following patient outcome data were collected EQ ‐5D ( E uro Q o L ) pre‐operatively and the R evised A merican P ain S ociety P atient O utcome Q uestionnaire ( APS ‐ POQ ‐R) at 24 hours postoperation; and EQ ‐5D, S hort‐ F orm‐12 ( SF ‐12) and APS ‐ POQ ‐ R at 7 days postoperation. The degree of association between pain and HRQ oL was assessed using P earson's correlation coefficient and multivariate generalized linear regression models. Results Of the 228 patients included, 166 patients provided data at 7 days. Sixteen percent reported severe pain ≥ 50% of the day at 7 days. The severity of pain on both the APS ‐ POQ ‐ R pain severity and interference and affective impairment domains at 7 days was highly correlated with a decrease in HRQ o L as assessed by the SF ‐12 Physical Component Score ( PCS ), SF ‐12 M ental C omponent S core ( MCS ), and EQ ‐5 D scores ( r = −0.34 to −0.61, P < 0.0001). Multivariate regression analyses showed that irrespective of confounding factors (eg, age, gender, and pre‐operative HRQ o L ) patients with severe postoperative pain experience important reductions in both physical and mental well‐being domains of their HRQ o L . Conclusions A proportion of patients continue to experience severe pain at 7 days postoperatively, even after minor surgery. HRQ oL is strongly associated with the level of pain and provides additional data on the impact of postsurgery pain on patient's function and well‐being. Additional studies are needed to elucidate the interaction between pain severity and HRQ oL during the peri‐operative period.