title: Waiting for elective surgery: effect on physical problems and postoperative recovery.
abstract: BACKGROUND
  Long waiting times for elective surgery pose a threat to the quality of care. Our study aimed to assess (i) the physical symptoms and disabilities patients experience during the wait, (ii) the perceived improvements after surgery and (iii) whether problems increase during the wait or longer waits affect postoperative outcomes.
  
  
  METHODS
  A cross-sectional questionnaire study with postoperative follow up was held among patients waiting for surgery of varicose veins (n = 176), inguinal hernia (n = 201) and gallstones (n = 128) in 27 hospitals.
  
  
  RESULTS
  During the wait, each group reported increased levels of pain and impaired mobility (Nottingham Health Profile, P < 0.05). However, 15-41% of patients had no or mild symptoms, whereas 5% of inguinal hernia patients had severe pain and 17% of gallstone patients reported >or=1 colic attacks per week. Surgery resolved symptoms in 86-95% of patients. The length of the wait was not associated with problems during the wait or with postoperative outcomes (multilevel regression analysis, P > 0.01).
  
  
  CONCLUSIONS
  Waiting for general surgery primarily prolongs the suffering from symptoms, which are relieved by surgery. Although the prioritization of patients with more severe symptoms would reduce the overall burden of waiting, patients with minimal symptoms may be advised to refrain from surgery.
authors.affiliation: Department of Public and Occupational Health, Institute for Research in Extramural Medicine, VU University Medical Center, Amsterdam, The Netherlands. j.oudhoff@vumc.nl
authors.forename: Jurriaan P
authors.initials: JP
authors.lastname: Oudhoff
authors.forename: Danielle R M
authors.initials: DR
authors.lastname: Timmermans
authors.forename: Dirk L
authors.initials: DL
authors.lastname: Knol
authors.forename: Albert B
authors.initials: AB
authors.lastname: Bijnen
authors.forename: Gerrit
authors.initials: G
authors.lastname: Van der Wal
mesh_terms: D017558:Elective Surgical Procedures / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D042882:Gallstones / Q000601:surgery; D006552:Hernia, Inguinal / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010352:Patient Dropouts; D013312:Stress, Physiological / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014648:Varicose Veins / Q000601:surgery; D014850:Waiting Lists