Pain Trajectories after Orthopedic Surgery in Older Adults: An Analysis of Predictors and Associations with Postoperative Outcomes
Authors' conclusion
Postoperative pain in older orthopedic patients followed four distinct trajectories that were influenced by baseline and perioperative factors. Specific pain trajectories were associated with adverse postoperative outcomes.
Study context
- Population
- Patients aged 65 to 90 yr undergoing orthopedic surgery with self-controlled analgesia
- Participants
- 710 patients
- Comparison
- Postoperative pain trajectories
- Primary endpoint
- Distinct postoperative pain trajectories (pain intensity with movement, 11-point NRS, twice daily)
- Follow-up
- 5 days
Methodological detailsgrowth mixture modeling, multinomial logistic regression, multivariable regression
- Growth mixture modeling
- Multinomial logistic regression
- Multivariable regression
Primary result
As reported in the abstract
Pain trajectory membership
Further findings
| Outcome | aOR (95% CI) | P value | |
|---|---|---|---|
| Preoperative analgesic use as predictor of trajectoryIncrease-decrease vs Slow decrease | 3.76 (1.53–9.23) | P = 0.004 | |
| Preoperative analgesic use as predictor of trajectorySlow increase vs Slow decrease | 3.89 (1.52–9.98) | P = 0.005 | |
| Dexmedetomidine in self-controlled analgesia as predictor of trajectoryRapid decrease vs Slow decrease | 0.47 (0.32–0.70) | P < 0.001 | |
| Dexmedetomidine in self-controlled analgesia as predictor of trajectoryIncrease-decrease vs Slow decrease | 0.15 (0.08–0.28) | P < 0.001 | |
| 0.050.21520Adjusted odds ratio (log scale) |
Postoperative outcomes by trajectory
- Rapid decrease vs slow decrease: more opioids required and more complications
- Increase-decrease vs slow decrease: more opioids required and lower physical domain quality of life score at 30 days
- Slow increase vs slow decrease: longer hospital stay after surgery
Original publication
Pain Trajectories after Orthopedic Surgery in Older Adults: An Analysis of Predictors and Associations with Postoperative Outcomes. Anesthesiology. Published 6 April 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →