Incidence and Factors Associated With Post-Sternotomy Pain Syndrome in the National Heart Institute, Malaysia

OBJECTIVE: To determine the incidence of poststernotomy pain syndrome (PSPS) after open cardiac surgery in 2021. To determine characteristics and assess the severity of symptoms in patients diagnosed with PSPS. To identify factors that can be associated with patients who were positive for PSPS.

DESIGN AND METHODOLOGY: This study used a retrospective observational approach. Logistic regression analysis was employed to identify factors associated with the positive group.

SETTING: This study included all adult patients who underwent open cardiac surgery at the National Heart Institute, Malaysia, in 2021.

PARTICIPANTS: A total of 1,395 patients were enrolled.

INTERVENTIONS: The study involved conducting phone interviews to assess the presence of PSPS, followed by administering the Brief Pain Inventory questionnaire in the positive group to identify characteristics and severity of chronic pain.

MEASUREMENTS AND MAIN RESULTS: The incidence of PSPS after open cardiac surgery in 2021 was 20.35%. A total of 17.7% of patients reported that pain affected their daily activities, sleep, or emotions. Univariate analysis identified factors associated with PSPS, including age <60 years old, body mass index >30 kg/m2, history of previous percutaneous coronary intervention, ejection fraction <50%, the absence of chronic kidney disease (CKD), and internal mammary artery harvesting (p < 0.05). Multivariate analysis revealed that 4 independent factors were associated with PSPS: age <60 years old, history of previous percutaneous coronary intervention, ejection fraction <50%, and the absence of CKD (as compared with CKD) (p < 0.05).

CONCLUSIONS: Poststernotomy pain syndrome is a complex issue affected by various factors. Although the pain score may not be as severe as previously believed, it remains crucial to recognize PSPS because a significant proportion of patients are affected.