Prolonged Opioid Use and Pain after Surgery: Comment

I read with great interest the article recently published in Anesthesiology, “Prolonged Opioid Use and Pain Outcome and Associated Factors after Surgery under General Anesthesia: A Prospective Cohort Association Multicenter Study” by Kuck et al.¹  The authors should be congratulated for undertaking such a labor-intensive study and applying a complex statistical analysis. However, the data presented in tables 1 and 2 suggest that the study population had Patient-Reported Outcomes Measurement Information System scores resembling the entirety of the U.S. adult population (50 ± 10).²  Does this represent an important limitation to support the conclusion that there was a relative limited relationship between psychosocial factors and persistent opioid use at 3 months? Maybe focusing on a population with Patient-Reported Outcomes Measurement Information System scores greater than 1 SD would provide more optimal conditions to assess such a relationship. Also, can the authors clarify the way they measured catastrophizing?...