Close correlation between patients' positive mood and postoperative complication burden in hepato-biliary-pancreatic...

The impact of preoperative mood on complications remains poorly understood in hepato-biliary-pancreatic (HBP) surgery.

This prospective cohort study included patients who underwent resection for pancreatic ductal carcinoma and cholangiocarcinoma. Preoperative positive mood were measured by Vigor-Activity score according to Profile of Mood States, 2nd edition. The primary outcome was the whole burden of complications, represented by the comprehensive complication index (CCI). Patients were divided into low- and high-positive mood groups by the median Vigor-Activity score. The impact of mood state on CCI was assessed by restricted cubic spline regression.

Between July 2021 and June 2022, 127 consecutive patients were enrolled. Preoperative findings and surgical procedures did not significantly differ between the low-positive (n = 64) and high-positive (n = 63) mood groups. The high-positive mood group had a significantly lower median CCI than the low-positive mood group (41.1 vs. 48.2, P = 0.026). The Vigor-Activity score had a nearly linear negative correlation with CCI and independently decreased CCI (P = 0.034).

Patients with preoperative high-positive mood had a lower CCI than those with low-positive mood after major HBP surgery. A patient's preoperative mood could affect the total burden of postoperative complications.