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Patient factors affecting their pattern of recovery after elective cesarean delivery
Abstract Number: F4B-3
Abstract Type: Original Research
Introduction: Although cesarean delivery is a common surgical procedure, pain scores and opioid use between individuals can differ significantly postoperatively. Previous work at our institution examined and modeled the day to day pain recovery patterns of 435 women for 60 days after elective cesarean delivery using daily diaries or texts (submitted for publication). Cluster analysis generated 6 latent class populations that differed >10-fold in the area under the pain vs time curve. The goal of the study was to define what patient factors predict cluster membership.
Methods: After IRB approval, we performed a retrospective chart review of the 435 patients enrolled in the previous study to collect 38 demographic and psychosocial characteristic obtained routinely during admission. A univariate analysis stratified by cluster membership was done with p<0.05 significant.
Results: The results of the univariate analysis are shown in Table 1. When analyzed by cluster membership, we found that patients in the cluster at highest risk for slow recovery were more likely to have symptoms of chronic pain or depression, be African American, receive clinical care from the university teaching service instead of private practice obstetricians, plan not to breastfeed, and receive a post-discharge prescription for oxycodone rather than hydrocodone.
Discussion: Although patients in the slow pain recovery group only account for 10% of all patients, this cluster group is at high risk of developing chronic pain. Identification of patient factors associated with slow recovery may help to change our care for these patients after cesarean delivery to hasten recovery patterns.