Leah C. Acker, MD, PhD<\/a>, an anesthesiologist at Duke Health.\u202f\u202f\u202f\u00a0<\/p>\nMore than 4 in 10\u202folder adults scheduled\u202ffor\u202fmajor surgeries,\u202fnot\u202fincluding heart or brain operations,\u202fsaid they\u202fexperienced\u202fmoderate to\u202fhigh distress, a level comparable to\u202fpatients with advanced cancer.\u202f<\/p>\n
Stress among cancer patients is often tracked, but the Duke study is one of the most in-depth looks at pre-surgery stress in the general geriatric surgical population. <\/p>\n
Surprisingly\u202fit\u202fwasn\u2019t\u202fhow intense the worry felt, but the number of stressors a patient faced before surgery that predicted worse outcomes.\u202fStress count was strongly correlated with pain levels and hospital stays. The odds of experiencing delirium grew with each additional stressor.\u00a0<\/p>\n
Acker described\u00a0an\u202f\u201coverwhelmed phenotype,\u201d\u202fin which\u202fsmall stressors\u202fpile\u202fup\u202fto the point of\u00a0hindering\u202frecovery.\u202f<\/p>\n
Among patients who experienced delirium, the median distress intensity was 3.5 (measured on a scale of 0 to 10) compared with 2 for those who did not.\u00a0<\/p>\n
Although the study\u202ffocused on adults age 65, the results may apply to surgical patients of all ages.\u202f\u202f\u00a0<\/p>\n
A wide net of worries\u202f\u00a0<\/p>\n
Anesthesiologist and cognitive neuroscientist Leah\u202fC.\u202fAcker, MD, PhD, leads a lab\u202fat Duke University School of Medicine that\u202fis\u202fstudying ways to improve recovery from\u202fsurgery and\u202fanesthesia.\u00a0\u00a0<\/p>\n
To measure stress, researchers used a three-minute, tablet-based version of the National Comprehensive Cancer Network Distress Thermometer with 132 patients between November 2022 and December 2024.<\/p>\n
Patients rated their distress before surgery, selected concerns from a 39-item checklist and shared open-ended thoughts.\u00a0<\/p>\n
Common\u202fpre-surgery\u202fworries included sleep and appetite changes, communication with the health care team, and family-related stress.\u202f\u202f\u00a0<\/p>\n
\u201cAs the anesthesiologist,\u202fI have things\u202fI\u2019m responsible for\u202fto keep\u202fa\u202fpatient safe,\u201d she said. \u201cBut patients have their own concerns too. The survey takes just minutes and gives us a window into what matters most to them, so we can tailor conversations or simple interventions that can make a difference.\u201d\u202f\u00a0<\/p>\n
When patients were asked to write about what caused them the most stress in the past month, tops were caregiving responsibilities and fear of losing independence.<\/p>\n
\u202f\u00a0
In write-in comments, others went deeper sharing personal worries that were immediate and tangible \u2014 concerns about break-ins, identity theft, home repairs, and bills. Others described existential concerns about\u00a0the\u202f\u201cgeneral direction of the country,\u201d and\u202fholding on to activities that bring them joy and meaning\u00a0like\u202ftraveling,\u202fconcerts,\u202fand\u202fgolfing.\u202f\u202f\u00a0<\/p>\n
Although\u202fmost of the group\u202fwere\u202fretired, many\u202fexpected to\u202fkeep up with daily demands\u00a0of caring for pets, spouses and grandchildren.\u202f\u202f\u00a0<\/p>\n
\u201cOverall,\u202fthese free-text responses highlight the complex and often unspoken concerns that weigh on geriatric patients as they await surgery,\u201d authors wrote.\u202f\u202f\u00a0<\/p>\n
\nHidden surgery risk for older adults\u202f\u00a0\n<\/p>\n
Because\u202fmost adults over age 65 will undergo surgery at least once,\u202fAcker says doctors need better ways to spot who may be at risk for problems after surgery.\u202f\u202f\u00a0<\/p>\n
One of the most serious\u202fpost-operative\u202frisks\u202fis\u202fdelirium, a sudden\u202fstate of confusion\u202fthat makes it hard to think\u202fclearly or\u202fto\u202ffollow\u202fa\u202fconversation. Delirium is particularly devastating for older adults.\u202fIt adds billions of dollars to hospital costs, often means longer\u202fhospital\u202fstays,\u202fand\u202feven one\u202fepisode can\u202fgreatly\u202fraise\u202fthe\u202frisk of developing dementia later\u202fin life.\u202f\u00a0<\/p>\n
\u201cThis became\u202fmore than a checklist,\u201d said Acker, an assistant professor of anesthesiology and\u202fassistant research professor in\u202fneurobiology at Duke School of Medicine.\u202f\u201cThe patients\u202fwere honest and vulnerable. You\u202fdon\u2019t\u202fknow what someone is carrying unless you ask \u2014\u202fand\u202fask in a structured way.\u201d\u202f\u202f\u00a0<\/p>\n
Aker says a larger study could pinpoint which stressors matter most, offering clearer insight into how patients can achieve the best possible recovery.\u00a0\u00a0<\/p>\n
Authors:\u202fIsabella\u202fKjaerulff; Heather Whitson; Sloan Soyster; Matthew Fuller; Mary Wright; Jeanna Blitz; Jeffrey\u202fBrowndyke; and Joseph Matthew, all of Duke University and Duke School of Medicine.\u202f\u202f\u00a0<\/p>\n
Funding:\u202f Support for the study was provided by the National Institutes of Health Institute on Aging (Grant Nos.\u202f1R03AG078891-01 and 1R01AG088329-01); Society for Neuroscience in Anesthesiology and Critical Care; Foundation for Anesthesiology Education and Research; Duke Claude D. Pepper Older Americans Independence Center; Duke Aging Center of Duke University; and the Duke Department of Anesthesiology.\u202f\u00a0<\/p>\n","protected":false},"excerpt":{"rendered":"Stress before surgery may matter more than doctors once thought. A new\u202fDuke University School of Medicine\u202fstudy finds\u202fthat even…\n","protected":false},"author":2,"featured_media":217844,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[10],"tags":[134,111,139,69,1518],"class_list":["post-217843","post","type-post","status-publish","format-standard","has-post-thumbnail","category-health","tag-health","tag-new-zealand","tag-newzealand","tag-nz","tag-research"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts\/217843","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/comments?post=217843"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts\/217843\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/media\/217844"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/media?parent=217843"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/categories?post=217843"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/tags?post=217843"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}