Evidence map›Paper›PMID 26883234›Full record

SynthesisBMJ open2016

Surgical complications and their impact on patients' psychosocial well-being: a systematic review and meta-analysis.

Anna Pinto, Omar Faiz, Rachel Davis, Alex Almoudaris, Charles Vincent

2 registry-linked trialsAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 98 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
98citing papers in PubMed, 9 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03759795 nacompletednot on this mapstarted 2018, after this paper: background citation

Ameliorating the Impact of Complications and Errors on Surgeons: Resilience Training for Surgeons.

TypeinterventionalSponsorBournemouth UniversityRan2018 to 2022Enrolled68ConditionsEffect of TrainingArmsACTr (Acceptance and Commitment Training)
NCT07464860 narecruitingnot on this mapstarted 2026, after this paper: background citation

A Box Breathing Intervention and the Surgical Stress Response in Older Adults Undergoing Total Knee Arthroplasty: A Randomized Controlled Feasibility Trial

TypeinterventionalSponsorUniversity of ArizonaRan2026 to 2026Enrolled32ConditionsSurgical Stress Response, Stress Physiological, Stress Physiology, Stress PsychologicalArmsA 5-minute Asynchronous Breathwork Intervention, A 5-minute Asynchronous Card Game Video
3 · Its place in the literature

Who cites it

98 citing papers in PubMed, 9 syntheses or guidelines pooled it.

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38 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Anna PintoDivision of Surgery, Department of Surgery & Cancer, Imperial College London, London, UK.
Omar FaizDivision of Surgery, Department of Surgery & Cancer, Imperial College London, London, UK.
Rachel DavisDivision of Surgery, Department of Surgery & Cancer, Imperial College London, London, UK.
Alex AlmoudarisDivision of Surgery, Department of Surgery & Cancer, Imperial College London, London, UK.
Charles VincentDepartment of Experimental Psychology, Oxford University, Oxford, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveSurgical complications may affect patients psychologically due to challenges such as prolonged recovery or long-lasting disability. Psychological distress could further delay patients' recovery as stress delays wound healing and compromises immunity. This review investigates whether surgical complications adversely affect patients' postoperative well-being and the duration of this impact.

methodsThe primary data sources were 'PsychINFO', 'EMBASE' and 'MEDLINE' through OvidSP (year 2000 to May 2012). The reference lists of eligible articles were also reviewed. Studies were eligible if they measured the association of complications after major surgery from 4 surgical specialties (ie, cardiac, thoracic, gastrointestinal and vascular) with adult patients' postoperative psychosocial outcomes using validated tools or psychological assessment. 13,605 articles were identified. 2 researchers independently extracted information from the included articles on study aims, participants' characteristics, study design, surgical procedures, surgical complications, psychosocial outcomes and findings. The studies were synthesised narratively (ie, using text). Supplementary meta-analyses of the impact of surgical complications on psychosocial outcomes were also conducted.

results50 studies were included in the narrative synthesis. Two-thirds of the studies found that patients who suffered surgical complications had significantly worse postoperative psychosocial outcomes even after controlling for preoperative psychosocial outcomes, clinical and demographic factors. Half of the studies with significant findings reported significant adverse effects of complications on patient psychosocial outcomes at 12 months (or more) postsurgery. 3 supplementary meta-analyses were completed, 1 on anxiety (including 2 studies) and 2 on physical and mental quality of life (including 3 studies). The latter indicated statistically significantly lower physical and mental quality of life (p<0.001) for patients who suffered surgical complications.

conclusionsSurgical complications appear to be a significant and often long-term predictor of patient postoperative psychosocial outcomes. The results highlight the importance of attending to patients' psychological needs in the aftermath of surgical complications.

Indexed as

HumansMental DisordersPostoperative ComplicationsQuality of LifeStress, PsychologicalSURGERY

Identifiers

PMID26883234
PMCPMC4762142

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.