Preoperative anxiety in patients undergoing minimally invasive thoracic surgery: A prospective study of predictors and Patient-Reported concerns

Preoperative anxiety is a frequent but underrecognized psychological response in surgical patients. Its prevalence and determinants among individuals undergoing video-assisted thoracoscopic surgery (VATS) remain insufficiently defined. In this prospective study, 540 patients scheduled for minimally invasive single-port VATS were evaluated for preoperative anxiety using the Hospital Anxiety and Depression Scale. Demographic, clinical, and surgical variables were collected, and patients' specific concerns and fears were analyzed. Logistic regression identified independent predictors, and a predictive model was developed. Overall, 22.4% of patients experienced preoperative anxiety. Independent predictors included age < 60 years, body mass index < 25 kg/m², lung nodule diameter > 1 cm, observation time > 1 month, preoperative comorbidities, and marital status. The most frequently reported concerns were long-term prognosis, postoperative complications, and physical discomfort, with notable variations by anxiety status, sex, and age. The predictive model demonstrated good discriminative ability, suggesting potential clinical utility. Preoperative anxiety remains common among patients scheduled for VATS. This study identified key demographic and clinical predictors, as well as patients' major concerns, providing a foundation for early recognition and intervention.