Early postoperative pain catastrophizing in patients with anal fistula and the construction of its prediction model

Objective To analyze the current situation of early postoperative pain catastrophizing in patients with anal fistula, screen relevant predictive indicators based on the bio-psycho-social model and ABC emotion theory, construct and verify the risk model of early postoperative pain catastrophizing in patients with anal fistula, and provide a basis for the clinical implementation of precise trauma-related nursing.

Methods A total of 165 patients undergoing anal fistula surgery were selected as the research subjects. The general information of patients was collected. The relevant scoring situations were collected using the catastrophical pain scale, family care index questionnaire (APGAR), post-traumatic stress disorder checklist-civilian version (PCL-C), Connor-Davidson resilience scale (CD-RSIC-10) and numerical rating scale (NRS), etc. The logistic regression was used to construct a pain catastrophizing risk model in patients with anal fistula in the early postoperative period, and the ROC curve was drawn to test the model efficacy.

Results Among 165 patients with anal fistula, 95 cases were positive for early postoperative pain catastrophizing, with a positive rate of 57.58%. The educational background, disease duration, APGAR, PCL-C, CD-RISC-10 and NRS might be the influencing factors of pain catastrophizing in patients with anal fistula (P ＜ 0.05 to P ＜ 0.01). A nomogram was constructed based on six risk variables. The area under the ROC curve of the model was 0.847 (95%CI: 0.788–0.906), indicating good discrimination. When the cutoff value of the ROC curve was 0.690, the sensitivity of the model was 70.5%, the specificity was 88.6%, and the Youden index was 0.591, indicating the best measurement efficacy of the model. The model had a good fit (χ² = 14.59, P = 0.07).

Conclusions The positive rate of early postoperative pain catastrophizing in patients with anal fistula is relatively high. The educational background, disease duration, APGAR, PCL-C, CD-RISC-10 and NRS may be the influencing factors of early postoperative pain catastrophizing in patients with anal fistula. The risk model constructed based on influencing factors has significant efficacy. The constructed nomogram can achieve rapid assessment, and provide a quantitative tool for identifying the population with early postoperative pain catastrophizing after anal fistula surgery.