Prevalence and Predictors of Preoperative Anxiety in Patients With An Intracranial Supratentorial Neoplasm Undergoing Surgery

Background:Preoperative anxiety is common among patients, particularly in neurosurgical patients. The aim of the study was to evaluate the incidence and predictive factors of preoperative anxiety using the state anxiety scale of the State-Trait Anxiety Inventory (STAI-S) among patients undergoing elective craniotomy for a supratentorial neoplasm. This study also determined the optimal Amsterdam Preoperative Anxiety and Information Scale (APAIS) score for the identification of preoperative anxiety in this cohort.Methods:Sixty patients aged 18 to 65 years with American Society of Anesthesiologists physical status score I/II scheduled for elective craniotomy for a supratentorial neoplasm were recruited into this prospective, observational study. Preoperative anxiety was assessed using STAI-S and APAIS questionnaires. Using STAI-S >= 37 to define preoperative anxiety, the optimal APAIS to identify preoperative anxiety was determined using receiver operating characteristic curve analysis. Logistic regression was performed to identify independent predictive factors for preoperative anxiety.Results:Sixty percent of patients had preoperative anxiety (STAI-S >= 37). An APAIS score of 10 identified preoperative anxiety with a sensitivity, specificity, and positive predictive value of 97%, 96%, and 97%, respectively. Right-sided tumor location (P=0.047) and need-for-information on surgery (P=0.007) were independent predictors of preoperative anxiety.Conclusions:Patients with supratentorial neoplasms have a high incidence of preoperative anxiety; an APAIS score of 10 is the optimal cutoff to identify anxious patients in the preoperative period. Need-for-information about surgery and right-sided tumor laterality are independent predictors of preoperative anxiety.