title: Impact of Anxiety in Ambulatory Superficial Venous Surgery: A Prospective Study Using the HADS-A Scale.
abstract: BACKGROUND
  The aim of the present prospective clinical study is to evaluate the impact of the level of anxiety in patients undergoing ambulatory superficial venous surgery (SVS) and to select a specific group of patients who need more of our attention to reduce the postoperative adverse events.
  
  
  METHODS
  Preoperative anxiety was assessed using the Hospital Anxiety and Depression Scale (HADS), especially the HADS-A (Anxiety subscale) in 340 consecutive patients undergoing elective SVS. Venous disease was assessed in all patients according to the established CEAP classification, the Venous Clinical Severity and the Venous Disability scores.
  
  
  RESULTS
  According to the HADS-A scores, we could distinguish two groups of patients, with (group A with score > 8; 61 patients) and without potential anxious state (group B with score < 7; 279 patients). Demographic data, varicose veins risk factors and preoperative symptoms were comparable in both groups. The median HADS-A score was 9 (8-17; IQR: 2) in group A and 3 (0-7; IQR: 3) in group B. The rate of complications or adverse events in the recovery room, the mean postoperative pain scores, the apprehension before discharge hospital and the incidence of unexpected hospitalisation rate were significantly higher in group A when compared with group B.
  
  
  CONCLUSIONS
  We observed that the presence of preoperative anxiety, even although infrequent, was associated with high incidence of complications or adverse events in the recovery room and a greater postoperative pain level. In this context, this group of patients needs more of our attention, particularly to limit potential anxiety and improve their satisfaction score.
authors.affiliation: a Department of Thoracic and Vascular Surgery , Belgium.
authors.forename: V
authors.initials: V
authors.lastname: Scavee
authors.affiliation: b Department of Anaesthesiology, Clinique Saint-Pierre, Louvain-La-Neuve , Belgium.
authors.forename: J-Ph
authors.initials: JP
authors.lastname: Dehullu
authors.affiliation: c Neuropsychiatrist , Belgium.
authors.forename: J-P
authors.initials: JP
authors.lastname: Scavee
authors.affiliation: b Department of Anaesthesiology, Clinique Saint-Pierre, Louvain-La-Neuve , Belgium.
authors.forename: I
authors.initials: I
authors.lastname: Michel
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000556:Ambulatory Surgical Procedures / Q000379:methods / Q000523:psychology*; D001007:Anxiety / Q000175:diagnosis* / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010149:Postoperative Pain / Q000453:epidemiology / Q000503:physiopathology; D057234:Preoperative Period; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D012737:Sex Factors; D016896:Treatment Outcome; D014648:Varicose Veins / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000379:methods / Q000523:psychology*