Characterizing the Burden of Chronic Sternal Pain Following Cardiac Surgery
Why this work is in the frame
A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.
Bibliographic record
Abstract
Chronic sternal pain (CSP) is defined as persistent sternal pain following a sternotomy procedure lasting at least 3-6 months, and that significantly impacts a patient’s health related quality of life (HR-QOL). The published prevalence of CSP is highly variable, ranging from 35.3% to as high as 88.3% at 3 months post-operatively. At 6 months, the prevalence generally decreases to 11% to 22.1%, and remains relatively stable at 12 months between 11% to 35%. This variability likely reflects the heterogeneity in population or the methods used for pain assessment. The pathophysiology of CSP is multifactorial. Nerve injury from direct surgical injury to the anterior rami of the intercostal nerves from harvesting of the internal mammary artery, sternal retraction, electrocautery, or sternal wires can lead to neuropathy and intercostal neuralgia. Musculoskeletal pain may develop from chondritis, rib or costal fractures, migration of steel sternal wires, sternal pseudoarthrosis or malunion. This is made worse through the process of central sensitization, which, when untreated, may progress to development of chronic pain. Overall, one can conclude that the prevalence and impact of chronic sternal pain is significant following cardiac surgery, and poses a barrier to recovery by negatively influencing a patient’s mental health and quality of life. Recently, published guidelines for Enhanced Recovery After Cardiac Surgery (ERACS) provide a series of preoperative, intraoperative and postoperative strategies to improve recovery of patients following surgery and expedite return to normal activities. However, the guidelines do not offer recommendations on how to support patients following discharge from hospital, where a large portion of their recovery occurs. In fact, as we move towards ERACS and fast track cardiac surgery patients, the burden of post-operative pain management and functional recovery will slowly begin to shift to the patients and/or their caregivers. It is therefore important to characterize and study the quality of a patient’s recovery following discharge from hospital, so we can devise and implement targeted care plans that begin in the preoperative period and extend well into the period following discharge from hospital. The purpose of this study is to determine the association between chronic sternal pain and quality of life, adjusting for covariates, at 6 and 12 months. We also aim to identify the prevalence of chronic sternal pain and its impact on quality of life at 6 and 12 months following cardiac surgery and to determine the relevant risk factors that predict the development of chronic sternal pain. With this information, we aim to build a prediction model of patients with CSP at 6 months. Our ultimate goal is to develop a foundation from which we can begin to plan and implement perioperative pain management strategies to better support cardiac surgery patients following discharge from hospital.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.023 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.004 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.010 | 0.005 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.016 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it