Risk factors and early warning scoring system for chronic postsurgical pain following video-assisted thoracoscopic surgery in elderly lung cancer patients: a retrospective cohort study.
Scoring system predicts chronic pain after lung cancer thoracoscopic surgery in elderly patients
Risk factors and early warning scoring system for chronic postsurgical pain following video-assisted thoracoscopic surgery in elderly lung cancer patients: a retrospective cohort study.
In elderly populations, the risk of chronic postsurgical pain is compounded by age-related physiological vulnerabilities, high comorbidity burden, and psychosocial factors that predispose to central sensitization and pain chronification.
This study aims to identify independent clinical risk factors for chronic postsurgical pain following video-assisted thoracoscopic surgery in elderly lung cancer patients and to develop a practical, evidence-based early warning scoring system to support preoperative risk stratification and targeted preventive interventions.
A retrospective cohort study was conducted on 200 elderly patients (aged ≥65 years) who underwent video-assisted thoracoscopic surgery for lung cancer from 12 November 2023 to 13 August 2025 at a tertiary care center and were categorized into the chronic postsurgical pain group (n = 100) and non-chronic postsurgical pain group (n = 100) based on pain persistence beyond 3 months postoperatively.
score correctly separates high from low risk patients most of the time
The overall incidence of chronic postsurgical pain was 50.0% (100/200) in this elderly cohort.
A 0-17 point early warning scoring system was established: low risk (0-4 points, chronic postsurgical pain probability 8.3%), moderate risk (5-8 points, 47.7%), and high risk (≥9 points, 84.4%).
This study identified seven independent risk factors for chronic postsurgical pain following video-assisted thoracoscopic surgery in elderly lung cancer patients and established a practical early warning scoring system with good predictive performance (AUC = 0.847), enabling preoperative risk stratification and facilitating targeted preventive interventions to improve long-term outcomes.
External multicenter validation is warranted before clinical implementation.