Anxiety and Treatment Outcomes

Do you have a mature, close loved one or friend that is going into surgery? You might find this post helpful.

Greater levels of anxiety can negatively impact treatment outcomes and likely rise patient suffering. Kassahun et al. (2022) designed a prospective observational study to determine whether preoperative patient‑reported anxiety negatively has an impact on major general surgery outcomes (p. 1). Most patients anticipating surgery are anxious, and to some extent anxiety is considered a natural reaction to the unpredictable and potentially threatening circumstances typical of the preoperative period. However, an extreme level of anxiety might have a negative effect on treatment outcomes, and this has been shown in patients in different types of medical settings.

For instance, Székely et al. studied patients who underwent cardiac surgery and discovered an independent association between anxiety and mortality (as cited in Kassahun et al., 2022, p. 2). Preoperative anxiety was evaluated in a group of elderly patients who underwent cardiac surgery by Williams et al. (2013, as cited in Kassahun et al., 2022), and considerably higher mortality was seen among older patients who experienced greater levels of preoperative anxiety. In this study, the most important exclusion criteria included: being under 18 years of age, outpatient surgical procedures, emergent surgical procedures, cancellation of a set procedure, acute psychiatric conditions, communication and cognitive illnesses, and an active history of alcohol and drug abuse.

In their study, Kassahun et al. (2022) studied surgical procedures and anxiety. Four hundred patients filled out the questionnaires and went through surgery, with an average break from questionnaire completion to surgery in just four days. In this group of 400, postoperative complications took place in 23.9% of the no-anxiety group, which amounted to 38 of 159 patients, and 28.6% in the anxiety group, which signified 69 of the 241 patients (p. 6). Overall, 15 patients passed after surgery, giving an in-hospital mortality rate of 3.8%. Analysis of the mortality rate by the group showed that 3.3% of the patients (8 of 241) who were anxious passed during hospitalization after surgery, when compared with 4.4% of the patients (7 of 159) who were not considered anxious (= 0.577). Therefore, the mortality rate of the anxiety group was fairly close to that of the no-anxiety group. From these statistics it is safe to say that anxiety does not generally affect the outcomes of surgery.

I have a few recommendations. First, it’s important to know the success rate of the surgery—if it’s risky, the surgery might not be worth it. Second, it’s good to talk with your doctor about their recommendations. Third, feeling anxious is something that can and should be anticipated. Fourth, talk to your doctor about your cortisol levels following the surgery.

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Kassahun, W. T., Mehdorn, M., Wagner, T. C., Babel, J., Danker, H., & Gockel, I. (2022). The effect of preoperative patient-reported anxiety on morbidity and mortality outcomes in patients undergoing major general surgery. Scientific Reports, 12(1), 6312.