• Roberta A Shea, Jo Ann Brooks, Nancy E Dayhoff, and Juanita Keck.
• Indiana University School of Nursing, Bloomington, Indiana, USA.
• Heart Lung. 2002 Nov 1;31(6):440-9.

ObjectiveThe purpose of this study was to determine whether postoperative pain intensity differs between elderly abdominal surgery patients in whom postoperative pulmonary complications (PPC) develop and those in whom they do not.MethodsThe exploratory secondary analysis of data from a prospective study of risk factors for PPC had a convenience sample of 86 patients (> or =60 years old) after abdominal surgery at 3 Midwestern hospitals. Daily measurements from postoperative day (POD) 1 to 6 included: pain (rated 0 to 10) at rest, with coughing, deep breathing, movement and walking, and frequency of ambulation.ResultsSixteen subjects (18.6%) had a PPC develop. Subjects with PPCs had higher mean pain intensities on all measures on each POD than those without. Those with PPCs had significantly higher pain intensities at rest on POD4 (P = .010), with deep breathing on POD2 (P = .015), POD4 (P = .009), POD5 (P = .006), and POD6 (P = .009), were up to a chair significantly fewer times on POD2 (P = .043), and walked significantly fewer times on POD5 (P = .002) and POD6 (P = .000) than those without PPCs. Length of stay for those with PPCs (mean, 17.9 days; standard deviation, 15.9 days; median, 10.0 days) was significantly longer than for those without PPCs (mean, 8.5 days; standard deviation, 4.8 days; median, 7.0 days; P = .000).ConclusionResults provide support for viewing pain as a factor that contributes to the development of PPCs among the elderly population after abdominal surgery. Therefore, nursing interventions of pain assessment and management, deep breathing, and ambulation may influence the incidence of this outcome.

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