Preoperative Anxiety in Patients Undergoing Outpatient Cancer Surgery
Objective: Our primary research aim was to determine the prevalence of preoperative anxiety in patients undergoing outpatient cancer surgery. Our secondary aim was to examine the association between preoperative anxiety and negative intraoperative and postoperative outcomes in patients undergoing ou...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2019-01-01
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| Series: | Asia-Pacific Journal of Oncology Nursing |
| Subjects: | |
| Online Access: | http://www.apjon.org/article.asp?issn=2347-5625;year=2019;volume=6;issue=4;spage=440;epage=445;aulast=Majumdar |
| _version_ | 1797765806884388864 |
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| author | Jennifer Ross Majumdar Emily A Vertosick Bevin Cohen Melissa Assel Marcia Levine Margaret Barton-Burke |
| author_facet | Jennifer Ross Majumdar Emily A Vertosick Bevin Cohen Melissa Assel Marcia Levine Margaret Barton-Burke |
| author_sort | Jennifer Ross Majumdar |
| collection | DOAJ |
| description | Objective: Our primary research aim was to determine the prevalence of preoperative anxiety in patients undergoing outpatient cancer surgery. Our secondary aim was to examine the association between preoperative anxiety and negative intraoperative and postoperative outcomes in patients undergoing outpatient cancer surgery, including increased anesthesia requirements, postoperative nausea and vomiting (PONV), extended overnight stay, total length of stay (LOS), transfer to hospital, surgical complications, and postoperative visits to urgent care centers (UCC). Methods: We conducted a retrospective cohort study to investigate the prevalence of preoperative anxiety and its association with postoperative outcomes in patients undergoing outpatient cancer surgery. Our retrospective cohort included 10,048 outpatient procedures performed on 8683 patients at a large comprehensive cancer center between January 1, 2016, and April 30, 2018. Results: The analysis included 8665 patients undergoing procedures at an outpatient facility over 16 months; 16.7% had preoperative anxiety. In patients with preoperative anxiety, higher rates of adverse outcomes were seen, including PONV (adjusted difference 1.8%, 95% confidence interval [CI] 0.12%, 3.4%, P = 0.029), unplanned overnight admission (adjusted difference 1.1%, 95% CI 0.07%, 2.0%, P = 0.021), and urgent care visits within 30 days (adjusted difference 1.5%, 95% CI 0.44%, 2.6%, P = 0.002). Conclusions: Even assuming a causal relationship between preoperative anxiety and postoperative outcomes, preventing one instance of PONV would require treating at least 30 patients for anxiety, and preventing longer-term outcomes such as urgent care visits or readmissions within 30 days would require treating even larger numbers of patients. Future studies should attempt to elucidate the causal pathway between preoperative anxiety and postoperative adverse events in outpatients undergoing outpatient cancer surgery. |
| first_indexed | 2024-03-12T20:15:27Z |
| format | Article |
| id | doaj.art-4a795ea6e8454a62a3253e6794244cad |
| institution | Directory Open Access Journal |
| issn | 2347-5625 2349-6673 |
| language | English |
| last_indexed | 2024-03-12T20:15:27Z |
| publishDate | 2019-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Asia-Pacific Journal of Oncology Nursing |
| spelling | doaj.art-4a795ea6e8454a62a3253e6794244cad2023-08-02T01:21:09ZengElsevierAsia-Pacific Journal of Oncology Nursing2347-56252349-66732019-01-016444044510.4103/apjon.apjon_16_19Preoperative Anxiety in Patients Undergoing Outpatient Cancer SurgeryJennifer Ross MajumdarEmily A VertosickBevin CohenMelissa AsselMarcia LevineMargaret Barton-BurkeObjective: Our primary research aim was to determine the prevalence of preoperative anxiety in patients undergoing outpatient cancer surgery. Our secondary aim was to examine the association between preoperative anxiety and negative intraoperative and postoperative outcomes in patients undergoing outpatient cancer surgery, including increased anesthesia requirements, postoperative nausea and vomiting (PONV), extended overnight stay, total length of stay (LOS), transfer to hospital, surgical complications, and postoperative visits to urgent care centers (UCC). Methods: We conducted a retrospective cohort study to investigate the prevalence of preoperative anxiety and its association with postoperative outcomes in patients undergoing outpatient cancer surgery. Our retrospective cohort included 10,048 outpatient procedures performed on 8683 patients at a large comprehensive cancer center between January 1, 2016, and April 30, 2018. Results: The analysis included 8665 patients undergoing procedures at an outpatient facility over 16 months; 16.7% had preoperative anxiety. In patients with preoperative anxiety, higher rates of adverse outcomes were seen, including PONV (adjusted difference 1.8%, 95% confidence interval [CI] 0.12%, 3.4%, P = 0.029), unplanned overnight admission (adjusted difference 1.1%, 95% CI 0.07%, 2.0%, P = 0.021), and urgent care visits within 30 days (adjusted difference 1.5%, 95% CI 0.44%, 2.6%, P = 0.002). Conclusions: Even assuming a causal relationship between preoperative anxiety and postoperative outcomes, preventing one instance of PONV would require treating at least 30 patients for anxiety, and preventing longer-term outcomes such as urgent care visits or readmissions within 30 days would require treating even larger numbers of patients. Future studies should attempt to elucidate the causal pathway between preoperative anxiety and postoperative adverse events in outpatients undergoing outpatient cancer surgery.http://www.apjon.org/article.asp?issn=2347-5625;year=2019;volume=6;issue=4;spage=440;epage=445;aulast=MajumdarAmbulatory surgerynursing assessmentoncologypatient outcomespostoperative nausea and vomiting |
| spellingShingle | Jennifer Ross Majumdar Emily A Vertosick Bevin Cohen Melissa Assel Marcia Levine Margaret Barton-Burke Preoperative Anxiety in Patients Undergoing Outpatient Cancer Surgery Asia-Pacific Journal of Oncology Nursing Ambulatory surgery nursing assessment oncology patient outcomes postoperative nausea and vomiting |
| title | Preoperative Anxiety in Patients Undergoing Outpatient Cancer Surgery |
| title_full | Preoperative Anxiety in Patients Undergoing Outpatient Cancer Surgery |
| title_fullStr | Preoperative Anxiety in Patients Undergoing Outpatient Cancer Surgery |
| title_full_unstemmed | Preoperative Anxiety in Patients Undergoing Outpatient Cancer Surgery |
| title_short | Preoperative Anxiety in Patients Undergoing Outpatient Cancer Surgery |
| title_sort | preoperative anxiety in patients undergoing outpatient cancer surgery |
| topic | Ambulatory surgery nursing assessment oncology patient outcomes postoperative nausea and vomiting |
| url | http://www.apjon.org/article.asp?issn=2347-5625;year=2019;volume=6;issue=4;spage=440;epage=445;aulast=Majumdar |
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