ArticleSurgery2019
Missed psychosocial risk factors during routine preoperative evaluations are associated with increased complications after elective cancer surgery.
Article in Surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
What it found
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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.
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Who cites it
7 citing papers in PubMed.
- Implementing PST in older adults facing major surgery: a randomised controlled pilot study.BMJ open · 2025Trial
- Mapping of Preoperative Screening Tools Reveals Urgent Need for Standardization in Gastrointestinal Cancer Surgery: A Scoping Review.World journal of surgery · 2026Article
- Systematic literature review on biopsychosocial factors in the surgical waiting list.Clinics (Sao Paulo, Brazil) · 2026Review
- Patient-reported health-related social needs obtained at the bedside and outcomes after elective major surgery.Surgery · 2025Article
- Impact of Patient Income and Insurance on Postoperative Mortality After Total Pancreatectomy for Pancreatic Neoplasms.Journal of surgical oncology · 2025Article
- Article
- Characteristics of hospital and health system initiatives to address social determinants of health in the United States: a scoping review of the peer-reviewed literature.Frontiers in public health · 2024Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
backgroundCertain behavioral traits and inadequate social support are known risk factors for complications after cancer surgery. Despite their importance, it is unclear whether conventional patient preoperative evaluation captures them. This study was conducted to assess concordance between documentation and patient survey of selected risk factors and to determine whether failure to document affected postoperative outcomes.
methodsAdult patients at a tertiary academic medical center were surveyed before abdominal cancer surgery to assess 6 psychosocial risk factors. Risk factors were also assessed by retrospective chart review and compared with survey results through concordance measures. Thirty-day postoperative complications were abstracted by chart review. Rates of major complications for those with and without clinically missed risk factors were compared.
resultsComparisons between chart review and screening survey revealed poor-to-moderate positive agreement (0%-47%) for 5 risk factors and strong negative agreement (82%-99%) among all risk factors. Kappa analysis demonstrated poor-to-fair agreement among 5 risk factors (κ = 0.112-0.423). The overall complication rate was 36%. The complication rate for patients with at least 1 clinically missed risk factor was 49% vs 24% in those without (P = .021), with a similar effect replicated for each individual risk factor.
conclusionThis study shows a high level of discordance between formal screening and routine clinician documentation in a preoperative setting for psychosocial risk factors. There is a significant association between missing these risk factors and worse postoperative outcomes. Future work should examine whether structured screening of psychosocial risk factors may improve preoperative risk stratification through proactive interventions.
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