A multicenter analysis of registry data on postoperative orthopedic pain: a retrospective cohort study

Background: Postoperative pain can lead to complications, prolonged hospital stays, and increased healthcare costs. Orthopedic surgeries are particularly associated with severe pain. This study aimed to identify orthopedic procedures that cause severe pain in hospitalized patients within 72 h post-surgery. Methods: Pain scores were retrospectively analyzed for patients undergoing inpatient orthopedic surgery between October 15, 2015, and December 31, 2019, at three hospitals. Patient and procedure details and maximum pain scores were collected up to 72 h postoperatively. Procedures were classified using the International Classification of Health Interventions and ranked by median numeric pain scores. Results: The analysis included 9,918 patients. Median highest pain scores were 4 (IQR 3–6) within 24 h, 4 (IQR 2–5) between 24 and 48 h, and 3 (IQR 2–4) between 48 and 72 h. Open reduction and device implantation into the humerus (e.g., plate fixation) had the highest median scores: 6 (IQR 4–7) at 3–48 h and 5 (IQR 4–6) at 48–72 h. Other high-pain procedures included open shoulder joint surgeries, ankle surgeries, and lumbar spine fusions. Conclusions: Surgeries involving the humerus, shoulder, and lumbar spine were associated with higher pain scores. Further studies incorporating analgesic data are needed to identify effective pain management strategies for these procedures.