术前焦虑与血管外科术后并发症相关：一项横断面研究。

Preoperative Anxiety is Associated With Postoperative Complications in Vascular Surgery: A Cross-Sectional Study.

机构信息

Center for Anesthesiology and Resuscitation, University Clinical Center of Serbia, Pasterova 2 St, 11000, Belgrade, Serbia.

Faculty of Medicine, University of Belgrade, Belgrade, Serbia.

出版信息

World J Surg. 2022 Aug;46(8):1987-1996. doi: 10.1007/s00268-022-06575-0. Epub 2022 May 4.

DOI:10.1007/s00268-022-06575-0

PMID:35507076

Abstract

BACKGROUND

Preoperative anxiety is associated with increased morbidity and/or mortality in surgical patients. This study investigated the incidence, predictors, and association of preoperative anxiety with postoperative complications in vascular surgery.

METHODS

Consecutive patients undergoing aortic, carotid, and peripheral artery surgery, under general and regional anesthesia, from February until October 2019 were included in a cross-sectional study. Anesthesiologists assessed preoperative anxiety using a validated Serbian version of the Amsterdam Preoperative Anxiety and Information Scale. Patients were divided into groups with low/high anxiety, both anesthesia- and surgery-related. Statistical analysis included multivariate linear logistic regression and point-biserial correlation.

RESULTS

Of 402 patients interviewed, 16 were excluded and one patient refused to participate (response rate 99.7%). Out of 385 patients included (age range 39-86 years), 62.3% had previous surgery. High-level anesthesia- and surgery-related anxieties were present in 31.2 and 43.4% of patients, respectively. Independent predictors of high-level anesthesia-related anxiety were having no children (OR = 0.443, 95% CI: 0.239-0.821, p = 0.01), personal bad experiences with anesthesia (OR = 2.294, 95% CI: 1.043-5.045, p = 0.039), and time since diagnosis for ≥ 4 months (OR = 1.634, 95% CI: 1.023-5.983, p = 0.04). The female sex independently predicted high-level surgery-related preoperative anxiety (OR = 2.387, 95% CI: 1.432-3.979, p = 0.001). High-level anesthesia-related anxiety correlated with postoperative mental disorders (r = 0.193, p = 0.001) and pulmonary complications (r = 0.104, p = 0.042). Postoperative nausea (r = 0.111, p = 0.03) and postoperative mental disorders (r = 0.160, p = 0.002) correlated with high-level surgery-related preoperative anxiety.

CONCLUSIONS

Since preoperative anxiety affects the postoperative course and almost every third patient experiences anxiety preoperatively, routine screening might be recommended in vascular surgery.

摘要

背景

术前焦虑与手术患者的发病率和/或死亡率增加有关。本研究旨在探讨血管外科患者术前焦虑与术后并发症的发生率、预测因素及相关性。

方法

本研究为一项横断面研究，连续纳入 2019 年 2 月至 10 月期间在全麻和区域麻醉下接受主动脉、颈动脉和外周动脉手术的患者。麻醉医生使用经过验证的塞尔维亚版阿姆斯特丹术前焦虑和信息量表评估术前焦虑。患者根据焦虑程度（低/高）分为低/高焦虑组，分为麻醉相关和手术相关。统计分析包括多变量线性逻辑回归和点双列相关。

结果

共纳入 385 例患者（年龄 39-86 岁），其中 62.3%有既往手术史。31.2%和 43.4%的患者存在高水平麻醉相关和手术相关焦虑。高水平麻醉相关焦虑的独立预测因素为无子女（OR=0.443，95%CI：0.239-0.821，p=0.01）、个人麻醉不良经历（OR=2.294，95%CI：1.043-5.045，p=0.039）和诊断后时间≥4 个月（OR=1.634，95%CI：1.023-5.983，p=0.04）。女性是高水平手术相关术前焦虑的独立预测因素（OR=2.387，95%CI：1.432-3.979，p=0.001）。高水平麻醉相关焦虑与术后精神障碍（r=0.193，p=0.001）和肺部并发症（r=0.104，p=0.042）相关。术后恶心（r=0.111，p=0.03）和术后精神障碍（r=0.160，p=0.002）与高水平手术相关术前焦虑相关。