33736 Identifying predictive factors for high preoperative anxiety in patients undergoing Mohs micrographic surgery

Abstract

Background: Preoperative anxiety plays an important role in patient experience before any surgical procedure, including Mohs micrographic surgery (MMS). We sought to identify factors which are predictive of high self-reported preoperative anxiety surrounding MMS. Methods: We prospectively administered a 22-question survey to 54 first-time patients undergoing MMS to gather demographic information, medical history, and self-reported preoperative anxiety scores. Preoperative anxiety scores were measured on an integer scale from 0-10 and stratified into quartiles. Univariate logistic regression was used to identify variables predictive of a self-reported anxiety score in the top versus bottom quartile. Results: Our cohort consisted of 54 Mohs patients, 43% female/57% male, ages 31 to 97. Patients with a self-reported diagnosis of anxiety were 9.0 times more likely report an anxiety score in the highest quartile (95% CI 1.82-44.59, P = .007), compared with those without a self-reported diagnosis of anxiety. Additionally, patients with an annual income less than $75,000 per year were 4.8 times more likely to report an anxiety score in the highest quartile (95% CI 1.14-20.27, P = .033), compared with patients making more than $75,000 per year. Conclusions: Patients with a prior diagnosis of anxiety and lower annual income were more likely to report higher preoperative anxiety before MMS. Identifying patients at increased risk of pre-operative anxiety may facilitate incorporating interventions, such as administering antianxiolytics or offering preoperative consultations, to improve the patient experience.