The impact of surgical complications on patient wellbeing: a longitudinal study

Abstract

Background: Adverse events in the hospital setting have a significant impact on patients’ health, time and finances. However, little is known about the impact of surgical complications on patients’ psychosocial outcomes. The objective of this study was to better understand the impact of surgical complications on patients’ physical and mental wellbeing. Methods: Data was collected from 785 patients undergoing major surgery in 29 hospitals in the UK. Patients were surveyed pre-surgery, on discharge and at 1 month, 4 months and 12 months post discharge. Demographic and clinical information was collected alongside measures of wellbeing (SF12), anxiety and depression (HADS), social support (MDSS), and coping (Brief COPE). Regression analysis explored the relationship between complications and wellbeing, with social support and patient coping styles tested as moderators. Findings: Of the 785 participants, 379 had a surgical complication; 72 were rated as being ‘severe’. At 1 month, complications had a significant impact on mental and physical wellbeing. Significantly reduced physical and mental wellbeing was still evident at 4 months. At 12 months the difference in wellbeing between patients with and without complications was not significant except for mental wellbeing in patients with ‘severe’ complications. Social support was shown to have a significant positive impact on wellbeing at various time points. Coping strategies were also found to moderate the impact on wellbeing. Discussion: Complications significantly reduce physical and mental wellbeing over an extended period of time. Social support from family members and health professionals can be instrumental for reducing the impact on wellbeing.