Analysis of Factors Contributing to Perioperative Mohs Micrographic Surgery Anxiety: Patient Survey Study at an Academic Center.

Abstract

High perioperative patient anxiety is predictive of worse postoperative pain and quality of life. Several Mohs micrographic surgery (MMS) patient characteristics influence anxiety; however, the contributions of certain factors remain uncertain. Investigate factors influencing perioperative MMS patient anxiety, especially those with debated impact or unclear data. The authors surveyed 145 adult patients receiving MMS performed by a single MMS surgeon from 2018 to 2020. Patients self-reported demographics, history, and 10-point visual analog scale anxiety assessments at multiple stages. Health care provider (HCP)-perceived anxiety assessments were queried. A stepwise multiple regression modeling approach was used to explore potential factors. Younger age, female sex, and a self-reported history of anxiety confirmed by prior HCP diagnosis were significant predictors of pre-MMS anxiety. Postoperative anxiety increased with more layers removed and higher pre-MMS anxiety. HCP-perceived patient anxiety increased with younger patient age, more layers removed, prior skin cancer removal, and HCP-perceived pre-MMS patient anxiety. Anxiety-reducing interventions should target young female patients with a history of HCP-diagnosed anxiety, and patients with more layers removed. Prior skin cancer removal is associated with increased HCP-perceived intraoperative patient anxiety; however, it is not significant for patient-reported anxiety. Pre-MMS consultation may not be effective for anxiety reduction.