Subjective Assessments and Serum Cortisol Levels as Risk Factors of Pain Persistence in the Late Postoperative Period in Old and Oldest-Old Patients

Postoperative pain is one of the most common postoperative complications, resulting in significant burdens and adverse outcomes among patients, notably the frailest ones. Predicting the likelihood of intense postoperative pain can help optimize a patient's recovery. The aims of this study were to build a prognostic model of pain persistence in elderly and senile patients in the late postoperative period, based on clinical and laboratory parameters of the early postoperative period, and to evaluate the potential for the model's application. The study included 201 male and female patients who had undergone surgery of any type from September 2019 to August 2020. The patients were divided into three groups: senile patients, elderly patients, and young patients (control group). All of the examined patients were measured for fasting cortisol on the mornings of the first and seventh days following surgery. A statistically significant increase in the probability of pain persistence in the late postoperative period with the increasing age of the patient was found. Age, pain severity scores on the seventh day after surgery, and cortisol concentration in the blood on the first day after surgery, are of prognostic value for the risk of persistence of postoperative-pain syndrome.