Women's Recovery from Sternotomy-Extension (WREST-E) Study: Examining Long-Term Pain and Discomfort Following Sternotomy and their Predictors

Kathryn M King ^1*, Monica Parry ², Danielle Southern ¹, Peter Faris ¹ and Ross T Tsuyuki ³

¹ University of Calgary, Canada
² Kingston General Hospital, Canada
³ University of Alberta, Canada

^* To whom correspondence should be addressed. E-mail: kingk{at}ucalgary.ca.

Accepted 11 June 2007

Abstract

Objective To examine incision and breast pain and discomfort, and their predictors in women 12-months following sternotomy.

Design Extension survey following participation in a clinical trial.

Setting Ten Canadian centers.

Patients Women (n=326) who completed the Women's Recovery from Sternotomy Trial

Interventions None

Main outcome measures Pain and discomfort data (numeric rating scales) collected by standardized interview at 5-days, 12-weeks and 12-months following sternotomy.

Results More patients reported having incision or breast discomfort (46.6%) than pain (18.1%) at 12-months post-operatively. No symptoms at 5-days post-operatively were significantly associated with symptom presence at 12 post-operative months. However, having incision pain and discomfort as well as breast pain and discomfort at 12 post-operative weeks was associated with incision pain (Odds Ratio [OR]=3.26, 95% Confidence Interval [CI] 1.51- 7.07), incision discomfort (OR=4.87, 95% CI 3.01-7.88), breast pain (OR=9.36, 95% CI 3.91-22.38), and breast discomfort (OR=6.42, 95% CI 3.62-11.37), respectively at 12 post-operative months. Increasing chest circumference was associated with having ongoing incision pain (OR=1.12, 95% CI 1.03-1.21) and breast pain (OR=1.10, 95% CI 1.00-1.22). Harvesting of bilateral internal mammary arteries (IMAs) was associated with having ongoing incision pain (OR=4.71, 95% CI 1.54-14.3), while harvesting only the left IMA was associated with having ongoing breast pain (OR=2.78, 95% CI 1.06-7.32) and breast discomfort (OR 1.80, 95% CI 1.02-3.19).

Conclusions Patients reported incision and breast pain and discomfort as long as 12-months post-sternotomy. Improved management of post-operative pain and discomfort up to at least 12-weeks following surgery may render reduced long-term pain and discomfort symptoms.

Keywords: breast, discomfort, outcomes, pain, sternotomy

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Wildgaard, K., Ravn, J., Kehlet, H. (2009). Chronic post-thoracotomy pain: a critical review of pathogenic mechanisms and strategies for prevention. Eur. J. Cardiothorac. Surg. 36: 170-180 [Abstract] [Full Text]