Global prevalence and determinants of preoperative anxiety among surgical patients: A systematic review and meta-analysis

• Published in: International journal of surgery open Vol. 25; pp. 6 - 16
• Main Authors: Abate, Semagn Mekonnen, Chekol, Yigrem Ali, Basu, Bivash
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 2020
• Subjects: Anxiety; Global; Preoperative; Prevalence; Surgery; Anxiety; Prevalence; Preoperative; Surgery; Global
• ISSN: 2405-8572; 2405-8572
• DOI: 10.1016/j.ijso.2020.05.010

Preoperative anxiety, otherwise managed preoperatively, can cause high rate of cardiac mortality, adverse effects during anesthetic induction and patient recovery which correlate with high postoperative pain, increased analgesic and anesthetic consumption, prolonged hospital stay, poor quality of life decrease satisfaction with perioperative care.
The systematic review and meta-analysis aimed to provide evidence on global prevalence and determinates of preoperative anxiety among surgical patients.
A three stage search strategy was conducted on PubMed/Medline, Cochran, Science Direct and LILACS databases. Publication bias was checked with a funnel plot and objective diagnostic test was conducted with Egger's correlation and Begg's regression tests.
The global pooled prevalence of preoperative anxiety among surgical patients was 48% (95% confidence interval (CI): 39 to 47%, 28 studies, 14652 participants. The systematic review and Meta-Analysis revealed that preoperative anxiety was approximately 4 times more likely in patients who had fear of complications, RR = 3.53(95 % confidence interval (CI: 3.06 to 4.07, six studies).
The review revealed that approximately fifty percent of patients experienced preoperative anxiety which entails the policy makers and health care stakeholders should implement mitigating strategies to prevent and manage preoperative anxiety.
This systematic Review and Meta-Analysis is registered in research Registry (UIN: researchregistry5619).
•Almost fifty percent of surgical patients experienced preoperative anxiety.•The global prevalence of preoperative anxiety among surgical patients is still very high.•Preoperative anxiety among surgical patients was the highest in African continent followed by Asian continent.•Fear of complication was the main independent predictor of preoperative anxiety.•Previous anesthesia or surgical exposure revealed a significant reduction in development of preoperative anxiety.