ArticleAnnals of surgery2017
The Fifth Vital Sign: Postoperative Pain Predicts 30-day Readmissions and Subsequent Emergency Department Visits.
Article in Annals of surgery, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 47 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
SIMPRO Research Center: Integration and Implementation of PROs for Symptom Management in Oncology Practice
Comparison of the Postoperative Analgesic Effects of Ibuprofen Versus Ketorolac in Patients Undergoing Orthopedic Surgery
Who cites it
47 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Gaps in standardized postoperative pain management quality measures: A systematic review.Surgery · 2022Pooled it
- Effect of electroacupuncture on pain after periodontal flap surgery: a randomized controlled trial.Journal of traditional Chinese medicine = Chung i tsa chih ying wen pan · 2025Trial
- The effect of narrative nursing on improving the negative emotions and quality of life of patients with moderate to severe cancer pain.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2025Trial
- Intraoperative Methadone in Next-day Discharge Outpatient Surgery: A Randomized, Double-blinded, Dose-finding Pilot Study.Anesthesiology · 2023Trial
- Analgesic effect of intercostal nerve block given preventively or at the end of operation in video-assisted thoracic surgery: a randomized clinical trial.Brazilian journal of anesthesiology (Elsevier)Trial
- Regional Anesthesia in Thumb Carpometacarpal Arthroplasty: Increased Costs Without Differences in Early Emergency Department Visits or Opioid Prescriptions.Journal of hand surgery global online · 2026Article
- Beyond Early Complications: Diabetic Neuropathy Is Associated With Progressive Failure, Reoperation, and Mortality After Ankle Arthrodesis.Orthopedic reviews · 2026Article
- Baseline Inflammatory Cytokines Moderate Associations Between Intraoperative Oxidative Stress and Chronic Postsurgical Pain After Total Knee Arthroplasty: An Exploratory Study.Journal of pain research · 2026Article
- The Economic burden of opioid-related serious adverse events and undertreatment of acute pain in the United States.Frontiers in public health · 2026Review
- Comorbid depression is associated with non-routine discharge following treatment of unruptured cerebral aneurysms.Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia · 2025Article
- The effect of occupational therapy services on hospital readmission for patients with cancer in acute care settings: a retrospective data analysis.Journal of cancer survivorship : research and practice · 2025Observational
- Dexmedetomidine-Loaded Hydrogel Microneedles Alleviate Acute Inflammatory Visceral Pain in Mice.Gels (Basel, Switzerland) · 2025Article
- Patient Performance of Care Tasks During Acute Hospitalisation: A Scoping Review.Journal of clinical nursing · 2025Article
- Association Between Opioid Use Disorder and Healthcare Spending and Utilization in Emergency Surgical Patients: A Retrospective Analysis Using Commercial Claims.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2025Article
- Factors associated with avoidable 30-day readmissions in patients with cancer: a single institution study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Article
- Are We Getting Better? Trends in 30-Day Readmission and Length of Stay Following Hip Fracture Surgery Among Older Adults: A Five-Year ACS-NSQIP Analysis.Geriatric orthopaedic surgery & rehabilitation · 2025Article
- Article
- Oxycodone prescription after inflatable penile prosthesis has risks of persistent use: a TriNetX analysis.International journal of impotence research · 2024Article
- A Qualitative Study of Electronic Patient-Reported Outcome Symptom Monitoring After Thoracic Surgery.The Journal of surgical research · 2024Article
- Postoperative Multimodal Analgesia Strategy for Enhanced Recovery After Surgery in Elderly Colorectal Cancer Patients.Pain and therapy · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
Abstract
objectiveWe hypothesized that inpatient postoperative pain trajectories are associated with 30-day inpatient readmission and emergency department (ED) visits.
backgroundSurgical readmissions have few known modifiable predictors. Pain experienced by patients may reflect surgical complications and/or inadequate or difficult symptom management.
methodsNational Veterans Affairs Surgical Quality Improvement data on inpatient general, vascular, and orthopedic surgery from 2008 to 2014 were merged with laboratory, vital sign, health care utilization, and postoperative complications data. Six distinct postoperative inpatient patient-reported pain trajectories were identified: (1) persistently low, (2) mild, (3) moderate or (4) high trajectories, and (5) mild-to-low or (6) moderate-to-low trajectories based on postoperative pain scores. Regression models estimated the association between pain trajectories and postdischarge utilization while controlling for important patient and clinical variables.
resultsOur sample included 211,231 surgeries-45.4% orthopedics, 37.0% general, and 17.6% vascular. Overall, the 30-day unplanned readmission rate was 10.8%, and 30-day ED utilization rate was 14.2%. Patients in the high pain trajectories had the highest rates of postdischarge readmissions and ED visits (14.4% and 16.3%, respectively, P < 0.001). In multivariable models, compared with the persistently low pain trajectory, there was a dose-dependent increase in postdischarge ED visits and readmission for pain-related diagnoses, but not postdischarge complications (χ trend P < 0.001).
conclusionsPostoperative pain trajectories identify populations at risk for 30-day readmissions and ED visits, and do not seem to be mediated by postdischarge complications. Addressing pain control expectations before discharge may help reduce surgical readmissions in high pain categories.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.