Preoperative Stress Tied to Postoperative Outcomes in Older Adults

Stressor count, but not intensity, is linked to postoperative length of stay, pain, and delirium
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THURSDAY, Jan. 8, 2026 (HealthDay News) -- Psychological distress is common among geriatric surgery patients, and greater preoperative stressor counts are associated with worse postoperative outcomes, according to a study published in the January issue of Anesthesiology.

Isabella Kjaerulff, from Duke University in Durham, North Carolina, and colleagues assessed preoperative distress measures in a general geriatric surgery cohort using a slightly modified National Comprehensive Cancer Network Distress Thermometer, and evaluated associations with postoperative outcomes. The analysis included 129 volunteers (aged 65 years and older) undergoing nonintracranial, noncardiac surgery.

The researchers found that 42.2 percent reported high distress intensity (≥4 of 10) preoperatively. The median stressor count was 2, with stressor count associated with postoperative hospital length-of-stay (Spearman's rs, 0.24), postoperative pain (rs, 0.25), and risk for postoperative delirium (odds ratio, 1.19). There was no association observed between distress intensity and outcomes. Stressors most associated with high distress included "changes in eating," "communication with the health care team," "sleep," and "worry or anxiety," all of which are potentially modifiable.

"As the anesthesiologist, I have things I'm responsible for to keep a patient safe," senior study author Leah C. Acker, M.D., Ph.D., also from Duke University, said in a statement. "But patients have their own concerns too. The survey takes just minutes and gives us a window into what matters most to them, so we can tailor conversations or simple interventions that can make a difference."

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