Preoperative anxiety linked to higher postoperative pain after foot, ankle surgery
BOSTON — Patients with higher levels of preoperative anxiety reported higher levels of pain and less function after elective foot and ankle surgery, according to study presented here.
“Because patients in the higher anxiety group had levels of pain one standard deviation above the general population, patient counselling may be necessary to help them understand their results,” Sandra Klein, MD, said at the American Orthopaedic Foot & Ankle Society Annual Meeting.
The retrospective study examined 88 patients who received elective foot and ankle surgery between May 2016 and December 2016 and excluded patients with diabetes and surgeries for infection, trauma or routine hardware removal. Researchers analyzed patients’ PROMIS anxiety score, pain interference, physical function and depression score before and after surgery. Patients were categorized into two groups: 25 patients with more emotional distress, indicated by PROMIS anxiety scores greater than 60; and 63 patients with less emotional distress, indicated by PROMIS anxiety scores less than 60. The groups were similar in age, sex and time of follow-up.
The study found patients with higher preoperative emotional distress reported more preoperative pain and worse preoperative function. Post-surgery, all patients experienced similar levels of improvement in pain and function. However, patients with higher PROMIS anxiety scores before surgery reported higher pain and less function 6 months after surgery than patients with less emotional distress before surgery. On average, patients with preoperative emotional distress had a pain score of 55.5, which was statistically significant according to Klein. – by Laura Kincaid
Klein, S, et al. Preoperative emotional distress negatively impacts patient-reported outcomes following foot and ankle surgery. Presented at: American Orthopaedic Foot & Ankle Society Annual Meeting; July 11-14, 2018; Boston.
Disclosure: Klein reports no relevant financial disclosures.