Unlocking patient insights: a prospective study on patient reported outcome measures in thoracic surgery

Patient-reported outcome measures (PROMs) offer the potential for enhancing treatment quality and supporting patient-centered care. However, it remains uncertain how effectively these measures correlate with clinical outcomes. This prospective observational cohort study included 107 adult patients undergoing elective thoracic surgery. PROMs assessing anxiety, depression, and pain perception were collected preoperatively and at 6–12 months postoperatively using the Hospital Anxiety and Depression Scale (HADS), the State–Trait Anxiety Inventory (STAI), the Pain Sensitivity Questionnaire (PSQ), and the Pain Catastrophizing Scale (PCS). Postoperative pain was assessed using the Numeric Rating Scale (NRS), and persistent pain at follow-up was defined as post-thoracotomy pain syndrome (PTPS). The primary endpoint was the longitudinal change in PROMs between preoperative assessment and follow-up. Secondary endpoints included subgroup analyses according to the type of surgical access (open and minimally-invasive), the type of locoregional anesthetic technique (epidural anesthesia, intercostal nerve block, local anesthetic infiltration), and the presence of acute and chronic postoperative pain (PTPS). Patients showed elevated scores at postoperative follow-up, with the exception of the HADS overall score, HADS-anxiety, and STAI, the latter of which demonstrated a significant decrease. No significant differences were found across subgroups based on procedure type, anesthesia method, or PTPS status, with the exception of a significant difference in HADS-depression scores in patients without PTPS. A decline in physical and psychological well-being was observed 6 to 12 months post-surgery, reflected in increased levels of pain, depression, and anxiety. Our study did not find evidence of an association between the PROMs assessed and variations in surgical procedures, anesthesia methods, or the presence of acute and chronic pain in this cohort. DRKS: DRKS00017798.