Pei-Shan Tsai
Taipei Medical University, Taiwan
Posters & Accepted Abstracts: J Diabetes Metab
Post-surgical neuropathic pain (PSNP) is observed in herniorrhaphy, mastectomy, amputation or coronary artery bypass grafting (CABG) patients. We elucidated PSNP risk factors using LHID2010, a database includes medical claims data and registration files for 1 million enrollees randomly selected from approximate 24 million registry for beneficiaries of Taiwan�??s National Health Insurance program. Patients undertook the surgery between January 2000 and December 2012 was included. Patients with a history of PSNP before surgery or age of less than 20 or more than 100 years were excluded. A total of 4647 patients (herniorrhaphy: 2564; mastectomy: 803; amputation: 902; CABG: 378) were included. Patients with at least two ambulatory visits for PSNP treatments were identified as the PSNP subjects. Patients without PSNP diagnosis were identified as the non-PSNP subjects. Subjects were tracked from surgery date until the end of 2013 or loss of follow-up. During 1-14 years of follow-up, PSNP incidence in patients undertook herniorrhaphy, mastectomy, amputation and CABG was 4.6%, 6.8%, 15.5% and 18.8%, respectively. After controlling for the potential confounders, multivariate logistic regression analyses revealed that diabetes mellitus was a strong risk factor of PNSP in patients undertook herniorrhaphy [odds ratio (OR)=30.71], mastectomy (OR=29.80), amputation (OR=54.62) and CABG (OR=209.62) (all P<0.001). In herniorrhaphy patients, PSNP risk factors also included hyperlipidemia, anxiety and use of anti-depressants and opioids (OR=1.81, 3.19, 2.35 and 1.78; all P<0.05). In mastectomy patients, risk factors also included hyperlipidemia, anxiety and use of anti-depressants (OR=3.84, 4.93 and 2.51; all P<0.05). In amputation patients, risk factors also included hyperlipidemia and use of non-steroid anti-inflammatory drugs and acetaminophen (OR=1.93, 12.49 and 13.05; all P<0.05). In CABG patients, risk factors also included hyperlipidemia, anxiety and use of anti-depressants (OR=6.06, 4.50 and 3.48; all P<0.05). Collectively, data from this population-based cohort study highlighted that diabetes mellitus is a strong predictor for PSNP. ptsai@tmu.edu.tw
