识别与乳腺癌手术后持续疼痛有关的因素，可以促进风险分层和个性化治疗。单一人群研究的普遍适用性有限，因为社会经济和遗传因素都会导致持续疼痛的发展。因此，这项前瞻性的多中心队列研究旨在从亚洲和美国女性的样本中开发预测模型。我们招募在KK女儿医院(KK Women's and Children's Hospital)和杜克大学医疗中心(Duke University Medical Center)接受乳腺癌手术的女性。记录术前患者和临床特征以及EQ-5D-3L健康状况。进行疼痛灾难化量表、中枢敏感化清单、应对策略问卷-修订版、简明症状清单-18、感知压力量表、机械时间总和和压痛门槛评估。持续疼痛的定义是手术后4个月疼痛评分≥3或疼痛影响日常生活。使用广义估计方程生成单变量关联。招募站点被迫进入多变量模型中，而在单变量分析中p＜0.2的危险因素被考虑进行向后选择。在210名患者中，135名(64.3%)出现了持续性疼痛。多变量模型取得AUC=0.807，有五个独立协会：年龄(每5年0.85 OR，95%CI 0.74-0.98)；糖尿病(OR 4.68，95%CI 1.03-21.22)；术前在乳房以外的部位疼痛评分(OR 1.48，95%CI 1.11-1.96)；以往乳腺炎病史(OR 4.90，95%CI 1.31-18.34)；以及感知压力量表(每5分1.35 OR，95%CI 1.01-1.80)，在调整招募站点、手术前乳房疼痛评分、手术前整体安静痛评分、术后非甾体抗炎药使用和疼痛灾难化量表后。未来研究应验证此模型，并评估预防性干预以降低持续性疼痛风险。©2023年麻醉师协会。

Identifying factors associated with persistent pain after breast cancer surgery may facilitate risk stratification and individualised management. Single-population studies have limited generalisability as socio-economic and genetic factors contribute to persistent pain development. Therefore, this prospective multicentre cohort study aimed to develop a predictive model from a sample of Asian and American women. We enrolled women undergoing elective breast cancer surgery at KK Women's and Children's Hospital and Duke University Medical Center. Pre-operative patient and clinical characteristics and EQ-5D-3L health status were recorded. Pain catastrophising scale; central sensitisation inventory; coping strategies questionnaire-revised; brief symptom inventory-18; perceived stress scale; mechanical temporal summation; and pressure-pain threshold assessments were performed. Persistent pain was defined as pain score ≥ 3 or pain affecting activities of daily living 4 months after surgery. Univariate associations were generated using generalised estimating equations. Enrolment site was forced into the multivariable model, and risk factors with p < 0.2 in univariate analyses were considered for backwards selection. Of 210 patients, 135 (64.3%) developed persistent pain. The multivariable model attained AUC = 0.807, with five independent associations: age (OR 0.85 95%CI 0.74-0.98 per 5 years); diabetes (OR 4.68, 95%CI 1.03-21.22); pre-operative pain score at sites other than the breast (OR 1.48, 95%CI 1.11-1.96); previous mastitis (OR 4.90, 95%CI 1.31-18.34); and perceived stress scale (OR 1.35, 95%CI 1.01-1.80 per 5 points), after adjusting for: enrolment site; pre-operative pain score at the breast; pre-operative overall pain score at rest; postoperative non-steroidal anti-inflammatory drug use; and pain catastrophising scale. Future research should validate this model and evaluate pre-emptive interventions to reduce persistent pain risk.© 2023 Association of Anaesthetists.