Preoperative Anxiety in Patients Undergoing Elective Surgery During a Healthcare Crisis: A Referral Hospital Experience.

Abstract

Objective: The psychological impact of healthcare crises is undoubted. Anxiety has a strong impact on the perioperative patients’ well-being and their subsequent postoperative recovery. The aim of this survey was to assess preoperative anxiety and its accentuating factors in patients undergoing surgery during a healthcare crisis.

Method: This study is a cross-sectional observational study. All adult patients undergoing elective surgery during December 2021 were assessed for eligibility. We excluded patients with any diagnosed psychiatric comorbidities. Anxiety was recorded using the modified Preoperative Anxiety Scale (mPAS), with permission by the authors [1]. mPAS consists of 4 sections: (i) demographics, (ii) baseline anxiety trait, (iii) anxiety due to general preoperative factors and (iv) anxiety due pandemic-specific factors. We summarized the results using descriptive and inferential statistics.

Results: We included 116 patients, (60 males, 51.7% and mean age 60.6±15.5 years) who underwent major (27,23.3%), moderate (49,42.3%), and minor (40,34.5%) surgical interventions. Six patients were excluded due psychiatric disorders. Based on American Society of Anaesthesiologists Physical Status (ASA-PS) they were mostly classified as ASA PS II (62,53.4%) and ASA PS III (29,25%). At baseline, of the 110 patients who completed the questionnaire, 30% (n=33) suffered from baseline anxiety according to mPAS. Severity of planned surgery (n=24, 21.8%) represented a major anxiety source, which was statistically significant for patients undergoing major surgery (p=0.026). However, pandemic-related factors were responsible of anxiety in 36 (32.7%) patients. The female gender and the ASA grade were significantly associated with the levels of COVID-19 anxiety.

Conclusions: During a healthcare crisis 30% of the patients experienced anxiety before surgery. The preoperative anxiety was further aggravated due to pandemic-related factors.