SP8.6 Postoperative recovery - is there a psychological impact? Evaluation of psychological impact following emergency surgery

Abstract

Abstract Aim Undergoing ‘Emergency operation’ (EO) is a stressful event for patients however, the impact on mental health has not been studied. Study aims to evaluate the psychological impact during early postoperative period following EO using the standardised Patient Health Questionnaire-4 (PHQ-4). Methods Prospective study from hospital database. Age>18years who underwent emergency general surgical procedures between November-December 2022 were included. Procedures were classed as major(laparotomy) or moderate/minor. Patients were contacted two to four weeks postoperative to answer four questions within PHQ-4, assessing mood, anhedonia, anxiety and nervousness. Frequency of experiencing those negative emotions was graded from 0 (not at all) to 3 (nearly everyday). Data was analysed to identify potential factors associated with higher PHQ-4 scores. P-value<0.05 was statistically significant. Results 19 patients participated in the survey; 10(52.6%) male and 8(42.1%) female. Median age was 45±40years. Overall, nearly one-third of patients experienced some psychological impact during early postoperative period. 4(5.3%) patients reported feeling nervous, 6(31.6%) reported anxiety, 7(36.8%) reported anhedonia and 5(26.3%) reported feeling low. 2(10.5%) patients reported feeling these emotions nearly everyday. 6(31.6%) patients underwent major surgery. Higher PHQ-4 scores were found in the major group(n=6/19(31.6%), 5±8) vs non-major(n=13/19(68.4%), 3±1; p=0.051). There was a positive correlation between postoperative length of stay and PHQ-4 score (Spearman coefficient R=0.67, p=0.0016). Conclusion Psychological impact was more pronounced in patients undergoing major surgery, particularly those with protracted recovery. Although limited by sample size, study reveals the need for formal psychological support for patients undergoing EO.