Catastrophizing and Depression, but Not Anxiety, Mediate the Relationship Between Educational Attainment and Pain Outcomes

pectus repair surgery between 2018-2022 (N=2,205, Age(median) = 22 years, 77% male, 79% Not Hispanic/Latinx).Measures of association were used to compare two cohorts: those with MBH diagnoses (n = 734, 33%) and those without (n=1,471, 67%).Patients with MBH comorbidities had a 79% increase in risk for healthcare utilization (inpatient/outpatient/emergency services or consultations; OR 2.01, 95% CI [1.46, 2.78], 90% increase in risk for surgical complications (additional medical care attributed to surgery; OR 2.01, 95% CI [1.46, 2.77], and a 351% increase in risk for prolonged procedural pain (OR 4.67, 95% CI [2.48, 8.77] when compared to patients without MBH comorbidities.Having MBH comorbidities reduced the probability of being prescribed both opioid and non-opioid analgesics by 10% (OR 0.743, 95% CI [0.303, 1.83]) and 8% (OR 0.79, 95% CI [0.438, 1.43]), respectively.MBH comorbidities increase risk for adverse outcomes (surgical complications, prolonged pain, and greater healthcare utilization) in pectus repair patients.It is troubling those with MBH comorbidities were somewhat less likely to be prescribed opioid/non-opioid analgesics given their increased risk for prolonged procedural pain.Clinical efforts that reduce these risks are needed.T a g g e d E n d