Finite mixture models based on pain intensity, functional disability and psychological distress composite assessment allow identification of two distinct classes of persistentspinal pain syndrome after surgery patients related to theirquality of life

Amine Ounajim (1, 2) , Maxime Billot (1) , Pierre-Yves Louis (3, 4) , Yousri Slaoui (2) , Denis Frasca (5, 6) , Lisa Goudman (7, 8) , Manuel Roulaud (1) , Nicolas Naiditch (1, 9) , Bertille Lorgeoux (1) , Sandrine Baron (1) , Kevin Nivole (1) , Mathilde Many (1) , Nihel Adjali (1) , Philippe Page (10) , Bénédicte Bouche (1) , Elodie Charrier (11) , Laure Poupin (11) , Delphine Rannou (11) , Géraldine Brumauld de Montgazon (12) , Brigitte Roy-Moreau (13) , Chantal Wood (1) , Raphael Rigoard (14) , Romain David (1, 15) , Maarten Moens (7, 8) , Philippe Rigoard (1, 10, 16)

1 PRISMATICS - prismatics
2 LMA [Poitiers] - Laboratoire de mathématiques et applications [UMR 7348]
3 PAM - Procédés Alimentaires et Microbiologiques [Dijon]
4 IMB - Institut de Mathématiques de Bourgogne [Dijon]
5 Department of Anaesthesiology and Critical Care, Poitiers University Hospital, 86021 Poitiers, France
6 INSERM UMR-1246, Universities of Nantes and Tours, 37044 Tours, France
7 Department of Neurosurgery, Universitair Ziekenhuis Brussel, 1090 Brussels, Belgium
8 STUMULUS Research Group, Vrije Universiteit Brussel, 1090 Brussels, Belgium
9 DynamE - Dynamiques européennes
10 Department of Spine Surgery & Neuromodulation, Poitiers University Hospital, 86021 Poitiers, France
11 Pain Evaluation and Treatment Centre, Poitiers University Hospital, 86021 Poitiers, France
12 Pain Evaluation and Treatment Centre, La Rochelle Hospital, 17000 La Rochelle, France
13 Pain Evaluation and Treatment Centre, Nord Deux-Sèvres Hospital, 79000 Niort, France
14 STIC - Service des Technologies de l’Information et de la Communication
15 Physical and Rehabilitation Medicine Unit, Poitiers University Hospital, University of Poitiers, 86021 Poitiers, France
16 PPrime [Poitiers] - Institut Pprime [UPR 3346]

Persistent Spinal Pain Syndrome Type 2 (PSPS-T2), (Failed Back Surgery Syndrome), dra-matically impacts on patient quality of life, as evidenced by Health-Related Quality of Life (HRQoL)assessment tools. However, the importance of functioning, pain perception and psychological statusin HRQoL can substantially vary between subjects. Our goal was to extract patient profiles based onHRQoL dimensions in a sample of PSPS-T2 patients and to identify factors associated with theseprofiles. Two classes were clearly identified using a mixture of mixed effect models from a clinical data set of 200 patients enrolled in “PREDIBACK”, a multicenter observational prospective studyincluding PSPS-T2 patients with one-year follow-up. We observed that HRQoL was more impactedby functional disability for first class patients (n= 136), and by pain perception for second class pa-tients (n= 62). Males that perceive their work as physical were more impacted by disability than painintensity. Lower education level, lack of adaptive coping strategies and higher pain intensity weresignificantly associated with HRQoL being more impacted by pain perception. The identification ofsuch classes allows for a better understanding of HRQoL dimensions and opens the gate towardsoptimized health-related quality of life evaluation and personalized pain management.

Mots clés: PSPS; FBSS; chronic pain; health-related quality of life; mixture models analysis; person-alized pain management; chronic pain after spinal surgery

Domaines: Statistiques [math.ST]; Chirurgie; Applications [stat.AP]

Amine Ounajim, Maxime Billot, Pierre-Yves Louis, Yousri Slaoui, Denis Frasca, et al.. Finite mixture models based on pain intensity, functional disability and psychological distress composite assessment allow identification of two distinct classes of persistentspinal pain syndrome after surgery patients related to theirquality of life. Journal of Clinical Medicine, 2021, 10 (20), pp.4676. ⟨10.3390/jcm10204676⟩. ⟨hal-03343635⟩