Prevalence and severity of pain, anxiety, stress, and sleep disturbances among surgical patients: a nationwide single-day multicentre flash mob study.

Abstract

Patient-reported outcomes (PROs) are subjective health indicators including pain, anxiety, stress, and sleep disturbances. Despite their frequent occurrence in the perioperative period and potentially severe consequences for postoperative recovery (for example prolonged length of hospital stay, cardiovascular events, development of chronic pain), these are not acknowledged as complications and their exact prevalence remains unclear. This study aims to assess the prevalence and severity of pre- and postoperative pain, anxiety, stress, and sleep disturbances among surgical patients. A nationwide single-day multicentre cross-sectional flash mob study was conducted in 29 Dutch hospitals. Adult surgical patients with an expected hospital stay of at least one night were included. Patients admitted for neurosurgery, cardiothoracic surgery, or orthopaedic surgery were excluded. Primary outcomes were self-reported pain, anxiety, stress, and sleep disturbances, as assessed with the Numeric Rating Scale, Visual Analogue Scale for Anxiety, Perceived Stress Scale, and the adapted Patient-Reported Outcome Measurement Information System respectively. Of the 1077 eligible patients, 733 (68%) patients (mean age of 64 ± 15.9 s.d. years, 51.8% male) completed participation. Moderate to severe pain was prevalent in 509 patients (69.7%) and occurred most frequently post-surgery. Anxiety occurred in 278 patients (38.1%) and was more prevalent preoperatively. Moderate to severe stress was reported by 272 patients (37.8%) with similar findings pre- and post-surgery. Sleep disturbances were prevalent in 440 patients (64.1%). Pain and anxiety were more severe in females. Sleep disturbances were more severe in patients with lower socioeconomic status. Pain, anxiety, stress, and sleep disturbances are highly frequent complications among surgical patients in Dutch hospitals. Considering the prevalence and severity, we suggest implementing these relevant additional measures for PROs as indicators for routine postoperative evaluation to facilitate their management.