{
  "abstract": "Purpose\n\nAcute pain following endoscopic retrograde cholangiopancreatography (ERCP) in patients with choledocholithiasis is common but remains insufficiently characterized. Most existing prediction models primarily emphasize procedural variables, with limited consideration of psychological factors. This study aimed to identify risk factors for post-ERCP acute pain and to develop a clinically applicable risk scoring model for early postoperative risk stratification.Patients and methods\n\nThis prospective observational cohort study at a tertiary hospital (January 2024-December 2025) enrolled consecutive patients undergoing ERCP for choledocholithiasis. Pain intensity was assessed using the Numeric Rating Scale (NRS) at 2, 8, and 24 hours post-procedure; the highest score across these time points was defined as peak postoperative pain, and NRS ≥ 4 was classified as moderate-to-severe pain. Preoperative anxiety (Self-Rating Anxiety Scale, SAS) and Type A behavior (Type A Behavior Pattern Scale, TABP) were evaluated. Independent predictors were identified using multivariable logistic regression, and a risk score was developed with internal validation via bootstrap resampling (1,000 iterations) and decision curve analysis (DCA).Results\n\nAmong 340 patients (mean age 58.4 ± 12.6 years; 53.5% male), 162 (47.6%) developed moderate-to-severe pain. Six independent predictors were identified: procedural duration > 45 minutes (OR = 2.12), stone diameter > 15 mm (OR = 2.24), postoperative 6-hour C-reactive protein (CRP) > 50 mg/L (OR = 1.83), preoperative anxiety (SAS ≥ 60; OR = 2.56), Type A behavior (TABP ≥ 37; OR = 1.80), and body mass index (BMI) ≥ 28 kg/m² (OR = 1.68). A significant interaction between anxiety and Type A behavior was observed (P = 0.009). The risk score ranged from 0 to 9 points and showed good discrimination (area under the curve [AUC] = 0.808; optimism-corrected AUC = 0.802) and acceptable calibration (Hosmer-Lemeshow P = 0.223). DCA demonstrated net clinical benefit across threshold probabilities of 15%-70%.Conclusion\n\nThis internally validated model, integrating preoperative, procedural, and early postoperative factors, may facilitate early post-procedure risk stratification and support timely risk-adapted monitoring and management. External validation is required before clinical application.",
  "abstract_shown": true,
  "affiliations": [
    "The Centre of Gallbladder Diseases, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, 200120, People's Republic of China.",
    "Department of Hepatobiliary and Pancreatic Surgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, 200120, People's Republic of China.",
    "Department of Anesthesiology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, 200120, People's Republic of China."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Shanshan Sun"
    },
    {
      "affs": [
        0
      ],
      "name": "Yongmei You"
    },
    {
      "affs": [
        0
      ],
      "name": "Xia Wang"
    },
    {
      "affs": [
        0
      ],
      "name": "Qian Cao"
    },
    {
      "affs": [
        0
      ],
      "name": "Xujing Chen"
    },
    {
      "affs": [
        1
      ],
      "name": "Hui Li"
    },
    {
      "affs": [
        2
      ],
      "name": "Xingchen Hu"
    },
    {
      "affs": [
        0
      ],
      "name": "Lili Ma"
    },
    {
      "affs": [
        0
      ],
      "name": "Huiren Zhuang",
      "orcid": "0000-0001-6715-3640"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/cgpfvnyemanrm.bib",
  "cited_by": 0,
  "doi": "10.2147/jpr.s630313",
  "fulltext_url": "https://europepmc.org/articles/PMC13726616",
  "id": "cgpfvnyemanrm",
  "issns": [
    "1178-7090"
  ],
  "landing_url": "https://europepmc.org/article/MED/42974466",
  "language": "eng",
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2740|Gallbladder and Bile Duct Disorders"
    ]
  ],
  "openalex": "W7224125874",
  "pdf_url": "https://europepmc.org/articles/PMC13726616?pdf=render",
  "pmcid": "PMC13726616",
  "pmid": "42974466",
  "published": "2026-10-29",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/cgpfvnyemanrm.ris",
  "sources": [
    {
      "first_seen": "2026-11-04T15:20:47Z",
      "native_id": "MED:42974466",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42974466"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2740|Gallbladder and Bile Duct Disorders",
      "subfield": "general"
    }
  ],
  "title": "Risk Factors and Development of a Risk Score Model for Acute Pain After ERCP in Patients with Choledocholithiasis.",
  "title_text": "Risk Factors and Development of a Risk Score Model for Acute Pain After ERCP in Patients with Choledocholithiasis.",
  "type": "peer-reviewed",
  "updated_at": "2026-11-04T15:20:47Z",
  "url": "https://research.draconitic.com/paper/cgpfvnyemanrm",
  "venue": "Journal of pain research",
  "versions": []
}