Advanced statistical approaches for predicting pain after pediatric thoracotomy: a cross-sectional study using zero-inflated and Poisson models.

Alessandro Vittori, Marco Cascella, Piergiacomo Di Gennaro, Giuliano Marchetti, Elisa Francia, Ilaria Mascilini, Riccardo Tarquini, Massimo Antonio Innamorato, Emiliano Petrucci, Franco Marinangeli, Sergio Coluccia, Sergio Giuseppe Picardo
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Abstract

Background: Thoracotomy is one of the surgical procedures most burdened by chronic post-operative pain. There is poor evidence regarding the possibility that even in pediatric patients, thoracotomy can be followed by post-operative pain. The primary objective of this analysis is to identify associations with home pain therapy, pain intensity, and possible protective factors acting on chronic pain in this population.

Methods: A retrospective cross-sectional study was conducted at Ospedale Pediatrico Bambino Gesù IRCCS. The study included pediatric patients undergoing thoracotomy. For statistical analyses, a logistic model and a zero-inflated strategy were implemented to explore associations and predict factors related to home-based analgesic therapy and pain intensity.

Results: Gender and age were identified as significant factors in the assignment of home therapy, with males having over seven times the risk compared to females (OR = 7.06, 95% CI = [2.11, 29.7]). At the last measurement, pain intensity was positively associated with age and the number of pain events during the week.

Conclusions: The study highlights significant factors influencing post-thoracotomy pain management in pediatric patients. These findings underscore the importance of tailored pain management strategies that consider gender and age to improve post-operative care and outcomes in pediatric thoracotomy patients.

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预测小儿胸廓切开术后疼痛的先进统计方法:使用零膨胀和泊松模型的横断面研究。
背景:胸廓切开术是术后慢性疼痛负担最重的外科手术之一。即使是小儿患者,胸廓切开术后也可能出现术后疼痛,但这方面的证据不足。本分析的主要目的是确定该人群与家庭疼痛治疗、疼痛强度以及可能的慢性疼痛保护因素之间的关系:一项回顾性横断面研究在 Ospedale Pediatrico Bambino Gesù IRCCS 进行。研究对象包括接受开胸手术的儿科患者。为了进行统计分析,研究人员采用了逻辑模型和零膨胀策略来探究和预测与家庭镇痛疗法和疼痛强度相关的因素:结果:性别和年龄是影响居家治疗的重要因素,男性的风险是女性的七倍多(OR = 7.06,95% CI = [2.11,29.7])。在最后一次测量中,疼痛强度与年龄和一周内疼痛事件的次数呈正相关:本研究强调了影响儿童患者胸廓切开术后疼痛治疗的重要因素。这些发现强调了考虑性别和年龄的定制疼痛管理策略对改善小儿胸廓切开术患者术后护理和预后的重要性。
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