DOI: 10.1093/bjs/znag087.145 ISSN: 0007-1323

SP 11.02 Repercussions of Emergency General Surgery: Evaluating Psychological Impacts Postoperatively

Lorcan Moore, Nida Khan, Christi Swaminathan

Abstract

Aim

Emergency surgery (ES) stands as a significant anxiety-inducing period no matter the operation. ES impacts have been scantily investigated, with factors influencing postoperative mental health and psychology being poorly understood. Study endeavours to investigate elements influencing postoperative psychological outcomes, and sub-analyses of ES-severity and correlations with psychological metrics using Public Health Questionnaire-4(PHQ-4).

Methods

Prospective data collection from hospital database of patients under general surgery emergency list in December 2025. Procedures were allocated severity levels according to NICE-guidance: minor, intermediate, major/complex. Patients were contacted 2-4 weeks postoperatively and emailed PHQ-4 alongside short-answer questions covering general mental-health and support systems post-procedures. PHQ-4 response frequencies were graded 0 (not at all) to 3 (nearly every day). Correlations between severity and PHQ-4 scores were sought for analysis and statistical significance (p-values<0.05).

Results

45 patients contributed to audit: 23(51.1%) male, 22(48.9%) female. Median age was 50±18 years. Minor, moderate, major group constituted 11(24.4%), 28(62.2%) and 6(13.3%) patients respectively. There was moderate positive correlation between severity and PHQ-4 (Spearman’s rank coefficient r=0.52, p=0.00026); stronger correlation between inpatient stay and PHQ-4. (r=0.60, p=0.000011). Anxiety and depressive PHQ-4-subscales received similar scores. Qualitative analysis revealed limited postoperative psychological support signposting; inpatient experiences with independence; feelings of vulnerability; and, counselling options as key psychological determinants - irrespective of severity.

Conclusion

Severity and inpatient stays were positively correlated with PHQ-4, to statistical significance. Although limited by operation variety and severity, study demonstrates greater understanding of ES psychological trajectories and necessity for established pre-/post-operative psychological support.

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