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

Background: 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. Objective: The systematic review and meta-analysis aimed to provide evidence on global prevalence and determinates of preoperative anxiety among surgical patients. Methods: 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. Results: 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 1/4 3.53(95 % confidence interval (CI: 3.06 to 4.07, six studies). Conclusion: 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. Registration: This systematic Review and Meta-Analysis is registered in research Registry (UIN: researchregistry5619). (c) 2020 The Authors. Published by Elsevier Ltd on behalf of Surgical Associates Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).