Prevalence of pre-operative anxiety among adult patients undergoing elective surgery: A prospective observational single-centre study

Salihah Asiri; Jed Duff; Jane Currie; Michelle Guilhermino

doi:10.26550/2209-1092.1270

Authors

Dr Salihah Asiri Umm Al-Qura University, Queensland University of Technology
Professor Jed Duff Queensland University of Technology, Royal Brisbane and Women’s Hospital
Jane Currie Queensland University of Technology
Michelle Guilhermino University of Newcastle

DOI:

https://doi.org/10.26550/2209-1092.1270

Keywords:

pre-operative anxiety, surgery, APAIS

Abstract

Objective: This study aimed to investigate the prevalence of pre-operative anxiety in elective surgical patients at a major metropolitan hospital in Australia.
Background: Globally, 310 million people are admitted for surgery every year. It is estimated that up to 80 per cent of these patients experience clinically relevant anxiety in the pre-operative period. Pre-operative anxiety can result in post-operative complications such as pain, delayed wound healing, surgical site infection, prolonged recovery and extended hospital stays. While preoperative anxiety has many negative consequences, this anxiety has often been overlooked in clinical practice.

Methods: A prospective study was conducted between November 2021 and June 2022, involving 308 adult patients scheduled for elective surgery. Preoperative anxiety levels were measured using the Amsterdam pre-operative anxiety and information scale (APAIS), and age, sex and surgery type were collected.

Results: In total, 308 patients were enrolled, more than half (58%, n=279) were women. The mean (± SD) APAIS score out of 20 was 8.69 (± 4.08). Almost one third (32.4%, n=100) of patients had significant pre-operative anxiety (APAIS score > 11/20). Women were three times more likely to experience anxiety than men (OR=3.39, 95% CI 1.97–5.82). Conversely, older patients were less likely to experience anxiety, with a reduction in anxiety of two per cent for each year above 18 years (OR=0.98, 95%CI 0.97–0.99). Patients reported higher anxiety levels related to the surgery itself compared to the anaesthesia, with mean scores of 5.04 (± 2.48) and 3.65 (± 2.07) out of 10, respectively. More than half the patients (54.9%, n=169) reported needing more information about anaesthesia and surgery.

Conclusions: Findings suggest that clinically relevant anxiety is common yet underdiagnosed. A higher prevalence is observed among females and those under the age of 30. The surgical procedure more than the anaesthesia was reported to cause higher anxiety.