What specific risk factors were found for preoperative anxiety in elective surgery?

Preoperative anxiety is common among patients scheduled for elective surgery and can lead to worse outcomes. Identifying who is at risk helps doctors provide better support. Research shows that specific patient characteristics and past experiences predict higher anxiety levels before surgery.

What the research says

In a large study of children, older age and having anxious parents were linked to higher anxiety levels before surgery ⁵. Children with low activity ratings, a history of poor medical encounters, and those who had not been in day care also showed more anxiety ⁵. A separate study of over 1,200 children found that younger age and behavioral problems were independent risk factors for high anxiety at the time of anesthesia induction ⁶.

For adults, a study of over 3,000 patients found that 40.5% experienced high levels of anxiety before their elective procedures ⁴. Specific fears ranked highest included concerns about anesthesiologist error, which was a major predictor of anxiety ⁴. Another study of over 1,000 patients identified various demographic, clinical, and social variables as potential predictors, leading to a model for risk stratification ¹.

Interventions like clown-themed programs for preschoolers and transcutaneous electrical acupoint stimulation (TEAS) have been shown to reduce anxiety, suggesting that modifiable factors like preparation and environment play a role ²³.

What to ask your doctor

• What specific fears do I have about anesthesia or surgery that might increase my anxiety?
• Does my history of poor medical experiences or behavioral issues put me at higher risk for preoperative anxiety?
• How might my parents' or family members' anxiety levels affect my own anxiety before surgery?
• Are there non-drug interventions, like distraction techniques or preparation programs, that could help reduce my anxiety?
• What screening tools do you use to assess my risk for preoperative anxiety?