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E-Patient Counseling Trial (E-PACO): Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy

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Published on: August 1, 2019

Association between preoperative anxiety and case cancellations: Prospective study.

Tina Ramishvili¹, Rafi Khandaker¹, Carina Himes¹

¹Department of Anesthesiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.

Journal of Clinical Anesthesia

|April 21, 2026

Summary

This summary is machine-generated.

High preoperative anxiety, experienced by nearly 20% of patients, independently predicts same-day surgical cancellations. Addressing patient anxiety may reduce these cancellations, improving surgical scheduling efficiency.

Keywords:

Case cancellations Perioperative care Preoperative anxiety

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Published on: August 1, 2019

Area of Science:

Anesthesiology and Perioperative Medicine
Psychological Medicine

Background:

Diagnosed anxiety disorders predict same-day surgical cancellations.
Many patients experience significant preoperative anxiety without a formal diagnosis.
Preoperative anxiety is a prevalent concern impacting surgical scheduling.

Purpose of the Study:

To investigate if high preoperative anxiety independently predicts same-day surgical case cancellations.
To assess the association between anxiety levels and surgical cancellations beyond known risk factors.

Main Methods:

Prospective study at Montefiore Medical Center (April 2023 - January 2025).
Anxiety assessed preoperatively using a 0-10 Numeric Rating Scale (NRS); high anxiety defined as NRS ≥5.
Modified Poisson and logistic regressions adjusted for known cancellation predictors.

Main Results:

19.3% of 6469 cases reported high preoperative anxiety, significantly more than those with a formal diagnosis (9.5%).
High anxiety was associated with a 1.7% increased risk of same-day cancellation (aRR 1.29, p=0.023).
Each point increase in NRS score dose-dependently increased cancellation risk (aOR 1.04, p=0.019), with 22.1% of cancellations attributable to anxiety.

Conclusions:

Significant preoperative anxiety affects 1 in 5 patients and independently predicts surgical cancellations.
Preoperative anxiety is a significant, modifiable factor contributing to one-fifth of same-day cancellations.
Preoperative interventions targeting anxiety may reduce surgical case cancellations.