LAUSR

Knowledge about psychological and psychosocial predictors of chronic post-surgical pain is important to identify patients at risk for poor outcomes. The objective of this systematic review with meta-analysis was to assess the effect of such predictors. A comprehensive search of the available literature on this topic was performed using the electronic databases PubMed, Scopus, Embase and PsycInfo. Estimates of the effect of each predictor were extracted and both a narrative and a quantitative synthesis of these estimates was performed. Multiple imputation was employed to take into account the effect of non-significant estimates in case they were not reported by original studies. From a sample of 8322 records, 83 articles were included in the narrative synthesis and 41 studies were employed to perform the meta-analyses. The narrative synthesis showed that evidence about the effect of psychological predictors is heterogeneous, with few expected predictors, such as optimism, mental health and surgical fear, consistently associated with chronic post-surgical pain. In contrast, the meta-analyses showed that state anxiety, trait anxiety, mental health, depression, catastrophizing and, to a lesser extent, kinesiophobia and self-efficacy, have a weak but significant association with chronic post-surgical pain. In conclusion, this study showed that psychological predictors have a significant association with chronic post-surgical pain and that state anxiety is the most explicative one.