METHODS: In this prospective cohort study, patients were defined as catastrophizers (PCS > 30), or non-catastrophizers (PCS ≤ 30). The primary outcome was the visual analog scale (VAS) pain score at 3-month follow-up. Secondary outcomes included length of stay (LOS) for the index hospitalization, total daily opiate analgesic intake, and VAS pain scores on postoperative days 0, 1, 2, and 3 through discharge. Multivariable regression was used to control for total daily morphine equivalent dose consumed during the stay in addition to other clinical and demographic factors.
RESULTS: There were 87 patients in the \"non-catastrophizing\" and 36 in the \"catastrophizing\" groups. There was no clinically significant difference in VAS pain scores between groups at 3-month follow-up. Patients with a length of stay (LOS) ≥ 3 postoperative days differed in VAS pain scores (\"non-catastrophizers\" = 5.08 vs. \"catastrophizers\" = 7.13; p = 0.002) and were 2.4 times more likely to be catastrophizers than non-catastrophizers (p = 0.042). There were no differences in the remaining secondary outcomes.
CONCLUSIONS: The pain catastrophizing scale is a poor predictor of postoperative pain at 3-month follow-up. However, it may be a risk factor for increased LOS.