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This systematic review with meta\u2010analysis aimed to identify and summarise the evidence of all prognostic factors for chronic post\u2010surgical pain after lung and pleural surgery. Electronic databases were searched for retrospective and prospective observational studies as well as randomised controlled trials that included patients undergoing lung or pleural surgery and reported on prognostic factors for chronic post\u2010surgical pain. We included 56 studies resulting in 45 identified prognostic factors, of which 16 were pooled with a meta\u2010analysis. Prognostic factors that increased chronic post\u2010surgical pain risk were as follows: higher postoperative pain intensity (day 1, 0\u201310 score), mean difference (95%CI) 1.29 (0.62\u20131.95), p\u2009&lt;\u20090.001; pre\u2010operative pain, odds ratio (95%CI) 2.86 (1.94\u20134.21), p\u2009&lt;\u20090.001; and longer surgery duration (in minutes), mean difference (95%CI) 12.07 (4.99\u201319.16), p\u2009&lt;\u20090.001. Prognostic factors that decreased chronic post\u2010surgical pain risk were as follows: intercostal nerve block, odds ratio (95%CI) 0.76 (0.61\u20130.95) p\u00a0=\u00a00.018 and video\u2010assisted thoracic surgery, 0.54 (0.43\u20130.66) p\u2009&lt;\u20090.001. Trial sequential analysis was used to adjust for type 1 and type 2 errors of statistical analysis and confirmed adequate power for these prognostic factors. In contrast to other studies, we found that age had no significant effect on chronic post\u2010surgical pain and there was not enough evidence to conclude on sex. Meta\u2010regression did not reveal significant effects of any of the study covariates on the prognostic factors with a significant effect on chronic post\u2010surgical pain. Expressed as grading of recommendations, assessment, development and evaluations criteria, the certainty of evidence was high for pre\u2010operative pain and video\u2010assisted thoracic surgery, moderate for intercostal nerve block and surgery duration and low for postoperative pain intensity. We thus identified actionable factors which can be addressed to attempt to reduce the risk of chronic post\u2010surgical pain after lung surgery.<\/jats:p>","DOI":"10.1111\/anae.16009","type":"journal-article","created":{"date-parts":[[2023,4,24]],"date-time":"2023-04-24T19:15:07Z","timestamp":1682363707000},"page":"1005-1019","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Prognostic factors for chronic post\u2010surgical pain after lung and pleural surgery: a systematic review with meta\u2010analysis, meta\u2010regression and trial sequential analysis"],"prefix":"10.1111","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9752-6962","authenticated-orcid":false,"given":"P. R. 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S.","family":"Guay","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, Critical Care and Pain Medicine Massachusetts General Hospital, Harvard Medical School  Boston MA USA"},{"name":"Picower Institute for Learning and Memory, Massachusetts Institute of Technology  Cambridge MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4492-1760","authenticated-orcid":false,"given":"M.","family":"Trivella","sequence":"additional","affiliation":[{"name":"Centre for Statistics in Medicine University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0122-9929","authenticated-orcid":false,"given":"M.","family":"Klimek","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia Erasmus University Medical Center  Rotterdam The 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