{"doi":"10.1016/j.sopen.2023.02.003","title":"Pain severity scale: A methodology for classifying postoperative pain severity by surgical procedure","abstract":"Background: Acute postoperative pain is common following many types of surgery, and a significant subset of patients experience severe pain, which can be difficult to manage and result in postoperative complications. Opioid agonists are commonly used to treat severe postoperative pain, but their use has been associated with adverse outcomes. This retrospective study uses data from the Veterans Administration Surgical Quality Improvement Project (VASQIP) database to develop a postoperative Pain Severity Scale (PSS) based on subjective pain reports and postoperative opioid requirements. Methods: -means clustering analysis was used to group the surgeries based on 24-h maximum pain, 72-h average pain, and postoperative opioid prescriptions. Results: -means clustering analysis showed two optimal grouping strategies; one with 3 and the other with 5 groups. Both clustering strategies produced a PSS that categorized surgical procedures with generally increasing pain scores and opioid requirements. The 5-group PSS accurately captured typical postoperative pain experience across a range of procedures. Conclusions: -means clustering produced a Pain Severity Scale that can distinguish typical postoperative pain for a large variety of surgical procedures based on subjective and objective clinical data. The PSS will facilitate research into the optimal postoperative pain management and could be used in the development of clinical decision support tools.","journal":"Surgery Open Science","year":2023,"id":363582,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":7,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.865,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":669235,"name":"Robert Lee","orcid":"0000-0002-4099-1625","position":1,"is_corresponding":false},{"id":545624,"name":"Peter L. Elkin","orcid":"0000-0001-9616-6811","position":2,"is_corresponding":false},{"id":1118026,"name":"James M. Hitt","orcid":"0000-0002-0987-0593","position":0,"is_corresponding":true}],"reference_count":24,"raw_metadata":null,"created_at":"2026-07-19T01:14:32.510714Z","pmid":"36926590","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}