Objectives
The aim of this study was to measure the level of preoperative anxiety in patients
scheduled for cardiac surgery, identify any influencing clinical factors, and assess
the relationship between anxiety and postoperative morbidity.
Design
A prospective and consecutive study.
Setting
A single university hospital.
Participants
The study comprised 200 patients scheduled for cardiac surgery.
Interventions
Each patient was asked to grade his or her preoperative anxiety level using the Visual
Analogue Scale for Anxiety, Amsterdam Preoperative Anxiety and Information Scale,
and set of specific anxiety-related questions. Demographic data (age, sex, body mass
index) and anesthetic and surgical data (American Society of Anesthesiologists physical
status, EuroSCORE surgical risk, preoperative length of stay, and previous anesthetic
experience) were registered. Also, postoperative morbidity was assessed.
Measurements and Main Results
Twenty-eight percent of the patients developed high preoperative anxiety. The mean
Amsterdam Preoperative Anxiety and Information Scale score was 11.4 ± 4.3, and the
mean Visual Analogue Scale for Anxiety score was 48 ± 21. Patients scheduled for coronary
artery bypass surgery, who had no previous anesthetic experience, and who were hospitalized
before surgery, had higher anxiety scores. Coronary bypass surgery (odds ratio 3.026;
1.509-6.067; p = 0.002) was associated independently with preoperative high-level
anxiety. Anxiety most commonly was caused by waiting for surgery, not knowing what
is happening, fearing not being able to awaken from anesthesia, and being at the mercy
of staff. Anxiety did not modify the postoperative course.
Conclusions
In patients waiting to undergo cardiac surgery, both fear of the unknown and lack
of information, especially related to the surgery, are crucial factors in high levels
of preoperative anxiety in cardiac surgery. Coronary bypass surgery is a determining
factor for preoperative anxiety. The anxiety level did not modify the postoperative
course in these patients.
Key Words
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Publication history
Published online: August 10, 2017
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