Abstract：
Pain intensity assessment scales are important in evaluating postoperative pain and guiding management. Different scales can be used for patients to self-report their pain, but research determining cut points between mild, moderate and severe pain has been limited to studies with < 1500 patients. We examined 13,017 simultaneous acute postoperative pain ratings from 913 patients taken at rest and on activity, between 4 h and 48 h following surgery using both a verbal rating scale (no, mild, moderate or severe pain) and 0-100 mm visual analogue scale. We determined the best cut points on the visual analogue scale between mild and moderate pain as 35 mm, and moderate and severe pain as 80 mm. These remained consistent for pain at rest and on activity, and over time. We also explored the presence of category disagreements, defined as patients verbally describing no or mild pain scored above the mild/moderate cut point on the visual analogue scale, and patients verbally describing moderate or severe pain scored below the mild/moderate cut point on the visual analogue scale. Using 30 and 60 mm cut points, 1533 observations (12%) showed a category disagreement and using 35 and 80 mm cut points, 1632 (13%) showed a category disagreement. Around 1 in 8 simultaneous pain scores implausibly disagreed, possibly resulting in incorrect pain reporting. The reasons are not known but low rates of literacy and numeracy may be contributing factors. Understanding these disagreements between pain scales is important for pain research and medical practice.
摘要：
疼痛强度评估量表在评估术后疼痛和指导管理方面很重要。不同的量表可以用于患者自我报告他们的疼痛，但是研究确定轻度之间的切点，中度和重度疼痛仅限于<1500例患者的研究.我们检查了913例患者在休息和活动时同时进行的13,017例急性术后疼痛评分，在手术后4小时至48小时之间，使用口头评定量表(没有，温和,中度或重度疼痛）和0-100毫米视觉模拟量表。我们在视觉模拟量表上确定轻度和中度疼痛之间的最佳切点为35mm，中度和重度疼痛为80毫米。这些对于休息和活动时的疼痛保持一致，随着时间的推移。我们还探讨了类别分歧的存在，定义为患者口头描述没有或轻度疼痛评分高于视觉模拟量表上的轻度/中度切点，和患者口头描述中度或重度疼痛评分低于视觉模拟量表上的轻度/中度切点。使用30和60mm切割点，1533个观测值（12％）显示类别分歧，并使用35和80毫米切割点，1632（13％）显示出类别分歧。大约八分之一的同时疼痛评分令人难以置信地不同意，可能导致不正确的疼痛报告。原因尚不清楚，但识字率和算术率低可能是促成因素。了解疼痛量表之间的这些分歧对于疼痛研究和医学实践很重要。
