Original article / research
Assessment of Preoperative Anxiety using the APAIS Score from Ward to Day of Surgery: A Prospective Cohort Study
UC12-UC16
Correspondence
Dr. Siri Kandavar,
Associate Professor, Department of Anaesthesiology, K S Hegde Medical Academy, Nithyananda Nagar, Mangaluru-575018, Karnataka, India.
E-mail: sirikandavar16@gmail.com
Introduction: Preoperative anxiety is commonly associated with adverse outcomes like increased anaesthetic needs and prolonged recovery. However, its trajectory from ward admission to surgery remains poorly characterised.
Aim: To assess the trajectory of preoperative anxiety using the Amsterdam Preoperative Anxiety and Information Scale (APAIS) from ward admission to the day of surgery.
Materials and Methods: This prospective cohort study was conducted in the Department of Anaesthesiology, K S Hegde Medical Academy (a tertiary care hospital ), Mangaluru, Karnataka, India, over six months from October 2022 to March 2023 and enrolled 65 adult patients (20-60 years, ASA I-II) undergoing elective major/minor surgery under general or regional anaesthesia using convenience sampling. Anxiety was assessed at three time points: before Pre-Anaesthetic Checkup (PAC), after PAC and on the day of surgery. Demographic data and its association with anxiety were recorded. Chi-square tests analysed associations. Paired t-tests assessed anxiety changes across time points using a Bonferroni-corrected significance threshold of p<0.017.
Results: Among 65 patients, mean age distribution was 20-34 years (23.1%), 35-44 years (46.1%) and >45 years (30.8%). Females comprised 64.6% and males 35.4%. American Society of Anaesthesiologists (ASA) status: I (72.3%), II (27.7%). Paired t-test showed a significant reduction in anxiety after PAC compared with pre-PAC levels (mean difference 0.969, t=3.484, p=0.001). Anxiety increased slightly on the day of surgery, but this was not significant compared with post-PAC scores (mean difference -0.277, t=-1.893, p=0.063). Anxiety remained significantly lower on the day of surgery compared with pre-PAC levels (mean difference 0.692, t=2.347, p=0.022). Chi-square analysis showed no significant associations between anxiety and age, gender, or co-morbidities at any time point (p>0.05). Information needs remained consistently low across all groups.
Conclusion: Preoperative anxiety significantly reduced following PAC and remained lower on the day of surgery, although this difference did not remain statistically significant after Bonferroni correction. Demographic characteristics such as age, gender and co-morbidities do not influence this trajectory, indicating that effective information delivery plays a greater role in reducing anxiety than patient demographics. The APAIS is a valuable tool for assessing anxiety trajectory in clinical practice.