SynthesisInternational orthopaedics2025
Preoperative anxiety assessment in orthopaedic surgery: a systematic review and meta-analysis.
Synthesis in International orthopaedics, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Explainable Machine Learning Models for Classifying Preoperative Anxiety in Patients With Femoral Neck Fractures: A Retrospective Cohort Study.Nursing open · 2026Observational
- Risk Factors for Postoperative Sleep Disturbance in Elderly Patients Undergoing Hip Arthroplasty Surgery: The Role of Preoperative Depression and Anxiety.Actas espanolas de psiquiatria · 2026Article
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposePreoperative anxiety (Pop-Anx) is highly prevalent among patients undergoing orthopaedic surgery. Pop-Anx can stem from fears related to the procedure, anaesthesia, or the recovery process. It has been linked to poorer postoperative outcomes, including greater pain, reduced function, and a lower quality of life. Despite its clinical significance, Pop-Anx is inconsistently assessed due to a lack of standardized tools and clear guidelines. The objective was to identify instruments used for measuring Pop-Anx in patients undergoing orthopaedic surgeries.
methodsA systematic search was conducted across five databases up to September 2024, following PRISMA guidelines. Data on anxiety assessment tools, timing, administration, and related outcomes were extracted. Meta-analyses were conducted on studies with a low risk of bias using random-effects models.
resultsScreening of the literature revealed that 42 studies assessed Pop-Anx, involving a total of 115,380 patients. Ten different tools were used to measure Pop-Anx, with the Hospital Anxiety and Depression Scale (HADS) being the most frequent. Significant variability was observed in assessment timing and methodology. A meta-analysis showed that Pop-Anx was positively correlated with postoperative anxiety (z = 0.60) and pain (z = 0.22) and negatively correlated with joint function (z = -0.25). Females reported higher Pop-Anx (g = 0.38). The timing of outcome assessment did not significantly moderate these relationships.
conclusionAlthough Pop-Anx is associated with worse postoperative outcomes, it is assessed using heterogeneous and sometimes inadequate tools. Standardized, context-specific assessment methods are needed. Despite its clinical relevance, Pop-Anx remains underassessed in some common orthopaedic procedures.
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