Impact of Preoperative Anxiety on Postoperative Pain Intensity and Length of Hospital Stay.
Keywords:
length of hospital stay, postoperative pain, Preoperative anxietyAbstract
Background: Preoperative anxiety is a common but often under recognized psychological factor influencing surgical outcomes. Elevated anxiety levels are associated with higher postoperative pain intensity, increased analgesic requirements, delayed mobilization, and prolonged hospital stay. These factors collectively affect recovery quality and increase healthcare costs.
Objective: To assess the impact of preoperative anxiety on postoperative pain intensity and the duration of hospital stay among patients undergoing elective surgery.
Methods: This study was conducted at Department of Surgery, Riphah International Hospital, Islamic International Medical College, Rawalpindi from January 2023 to June 2023 in clinical setting. Preoperative anxiety was measured using the Hospital Anxiety and Depression Scale (HADS-A), while postoperative pain was assessed using the Visual Analogue Scale (VAS) at 6, 12, and 24 hours after surgery. Length of hospital stay was recorded in hours and days. Data analysis was performed using SPSS version 24. Associations were evaluated using the chi-square test, independent t-test, and Pearson correlation, followed by multivariate regression to identify independent predictors.
Results: Among the 100 participants, the mean age was 45.6 ± 12.3 years. Based on HADS-A scoring, 64% of patients had preoperative anxiety. Patients with higher anxiety scores demonstrated significantly greater postoperative pain at all measured intervals (6, 12, and 24 hours). The mean pain score in the high-anxiety group was 6.7 ± 1.5, compared with 4.8 ± 1.3 in the low-anxiety group (p = 0.001). Length of hospital stay was also significantly longer in anxious patients (4.3 ± 1.2 days) compared with those with lower anxiety (3.0 ± 0.9 days) (p = 0.010). Multivariate regression confirmed preoperative anxiety as an independent predictor of higher postoperative pain scores and prolonged hospital stay.
Conclusion: Preoperative anxiety is significantly associated with increased postoperative pain and longer hospital stay. Routine psychological screening and anxiety-relief interventions before surgery may help improve postoperative outcomes.
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