• Reg Anesth Pain Med · Nov 2024

    Prevalence and risk factors for chronic postamputation pain requiring analgesia or nerve interventions: a population-based study in East Asia.

    • Wen-Chih Liu, Fu-Wei Su, Sheng-You Su, Chen-Hao Chiang, Shu-Hsin Yao, Chia-Lung Shih, and Kyle R Eberlin.
    • Department of Orthopedic Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
    • Reg Anesth Pain Med. 2024 Nov 20.

    BackgroundPostamputation pain (PAP) is underexplored in East Asian populations, with most data originating from Western countries. This study aimed to investigate the prevalence and risk factors of PAP in East Asian individuals who underwent surgical amputation, particularly those requiring subsequent analgesia or nerve interventions.Materials And MethodsThe study used data from the Longitudinal Health Insurance Database, encompassing claims from 2 million randomly selected individuals out of 23.5 million enrolled in Taiwan's National Health Insurance Research Database from 2000 to 2019. The risk factors for PAP were analyzed using multivariable regression, considering criteria such as chronic postamputation pain, symptomatic neuroma treatment, chronic analgesia use, and nerve interventions.ResultsAmong the 7287 amputees (mean age 59.5 years; 65.1% male), 18.1% (95% CI 17.2%, 19.0%) (1318 patients) experienced PAP requiring intervention. Significant risk factors included cancer (OR 2.20 (95% CI 1.27, 3.68)), peripheral artery disease (OR 2.11 (95% CI 1.66, 2.69)), infection (OR 1.93 (95% CI 1.55, 2.40)), diabetes mellitus (OR 1.85 (95% CI 1.45, 2.37)), and a higher Elixhauser Comorbidity Index (OR 1.04 (95% CI 1.02, 1.06)). Prior radiculopathy (OR 1.30 (95% CI 1.13, 1.51)) and myelopathy (OR 1.33 (95% CI 1.14, 1.55)) also increased pain odds, while age showed a slight inverse association (OR 0.99 (95% CI 0.98, 0.99)).ConclusionThe prevalence of PAP requiring subsequent analgesia or nerve interventions in this East Asian population is 18.1%. Identified risk factors include multiple medical comorbidities and pre-existing radiculopathy or myelopathy. These findings highlight the important considerations for both clinical practice and future research directions.© American Society of Regional Anesthesia & Pain Medicine 2024. No commercial re-use. See rights and permissions. Published by BMJ.

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