One in four day-case patients has function-limiting pain a week later

Design

National prospective observational cohort

Population

7,839 adults after day-case surgery in the UK

Primary outcome

Pain severity and pain-related functional impairment over 7 days

Effect

Poor pain outcome 33.5%; function impaired by pain at day 7 in 26.3%

POPPY, a national prospective UK study published in Anaesthesia, followed 7,839 adults after day-case surgery, with pain, function and quality of recovery measured on days 1, 3 and 7; 7,331 responded on day 7.

Pain scores fell over the week, but pain still impaired function in 26.3% at day 7, and 33.5% had a poor pain outcome (score above 4 of 10) at some point in the first week. Poor pain was associated with treatment for anxiety or depression, chronic pain, frailty, larger operations and head and neck surgery; older age was associated with less. Poor function was associated with larger operations, orthopaedic surgery, chronic pain and frailty. Opioid-naive patients did better on both.

Day surgery is judged by discharge rates and readmissions, not by how patients function at home. These data show recovery is incomplete for many at a week, and the risk factors are identifiable at pre-assessment. This is an observational association study; it names who to target, not what intervention works.

• Identify day-case patients with chronic pain, frailty, anxiety or depression, or current opioid use at pre-assessment.
• Give these patients a written analgesia plan for the full first week, not just the first 48 hours.
• Set expectations that pain may still limit activity at a week, especially after orthopaedic or head and neck surgery.
• Arrange a follow-up contact for high-risk patients rather than relying on them to call.

Why it matters

Day-case success measured at discharge hides a large burden of unrelieved pain at home.

Don't overread it

Observational; the risk factors are associations and the study does not test any intervention.

The statistics, in plain English

The percentages use different denominators (4,854 and 4,348) because not every patient answered every question, so the true rates could shift slightly. The associations are adjusted, but the abstract does not give their effect sizes.

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