{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T05:54:47Z","timestamp":1781848487261,"version":"3.54.5"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T00:00:00Z","timestamp":1781827200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100018684","name":"National Health Commission of the People's Republic of China","doi-asserted-by":"publisher","award":["WKZX2024CX301202"],"award-info":[{"award-number":["WKZX2024CX301202"]}],"id":[{"id":"10.13039\/501100018684","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic postsurgical pain (CPSP) is a major complication following video-assisted thoracoscopic surgery (VATS) for lung resection. Despite its clinical importance, the reported incidence of CPSP varies considerably across studies, and a standardized tool for risk prediction remains lacking. This study aimed to identify predictors associated with CPSP after VATS lung resection within a single-center prospective observational cohort and to develop predictive models to guide personalized analgesic strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Clinical data were analyzed from patients who underwent thoracoscopic pulmonary resection at Tangdu Hospital between August 2024 and July 2025. Eligible patients were randomly allocated into a training cohort (80%) for model development and an internal validation cohort (20%) for model validation. Acute pain was assessed using the highest Numerical Rating Scale (NRS) score recorded within 72 h postoperatively, while CPSP was evaluated at 3 months after surgery. Patients were dichotomized based on the presence of CPSP into the CPSP group and the non-CPSP group. Variables with a\n                      <jats:italic>P<\/jats:italic>\n                      -value &amp;lt;0.1 in univariate analysis were entered into multivariate logistic regression to establish a prediction model for CPSP using R software.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 744 patients were included in this study, with 595 assigned to the training set and 149 to the validation set. Among all patients, 284 (38.1%) developed CPSP. The incidence rates in the training and validation cohorts were 37.8 and 36.9%, respectively. Multivariate logistic regression identified gender, postoperative acute pain, postoperative pneumonia, duration of chest tube drainage, and opioid rescue dose (in morphine milligram equivalents) as independent predictors associated with CPSP. The nomogram model constructed based on these predictors demonstrated good performance, with an area under the curve (AUC) of 0.880 (95% CI: 0.850\u20130.910). Calibration curve analysis confirmed the high predictive accuracy of the model (Hosmer\u2013Lemeshow test,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.737), and decision curve analysis indicated a significant clinical net benefit. Furthermore, in the validation cohort, the model maintained good discriminative ability (AUC = 0.829) and calibration (Hosmer\u2013Lemeshow test,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.765), enabling reliable individualized risk prediction.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>CPSP remains highly prevalent after thoracoscopic pulmonary resection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1787875","type":"journal-article","created":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T05:47:30Z","timestamp":1781848050000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Development and validation of a predictive model for chronic pain after thoracoscopic pulmonary resection"],"prefix":"10.3389","volume":"14","author":[{"given":"Yue","family":"Shang","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Tangdu Hospital, The Fourth Military Medical University","place":["Xi'an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenyang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Tangdu Hospital, The Fourth Military Medical University","place":["Xi'an, China"]},{"name":"Graduate School, Yan'an University","place":["Yan'an, Shaanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiameng","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Tangdu Hospital, The Fourth Military Medical University","place":["Xi'an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenlun","family":"Zhong","sequence":"additional","affiliation":[{"name":"Graduate School, Xi'an Medical University","place":["Xi'an, Shaanxi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changjun","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Tangdu Hospital, The Fourth Military Medical University","place":["Xi'an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,19]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"229","DOI":"10.3322\/caac.21834","article-title":"Global cancer statistics 2022: Globocan estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J Clin."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1976","DOI":"10.1097\/j.pain.0000000000001939","article-title":"The revised international association for the study of pain definition of pain: concepts, challenges, and compromises","volume":"161","author":"Raja","year":"2020","journal-title":"Pain."},{"key":"B3","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1097\/j.pain.0000000000001413","article-title":"The IASP classification of chronic pain for ICD-11: chronic postsurgical or posttraumatic pain","volume":"160","author":"Schug","year":"2019","journal-title":"Pain"},{"key":"B4","doi-asserted-by":"publisher","first-page":"311","DOI":"10.1111\/anae.15609","article-title":"The prospect working group *of the European society of regional anaesthesia and pain therapy. 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