Prevalence and determinants of misconceptions regarding postoperative complications among surgical patients

Misconceptions regarding postoperative complications may influence patients’ understanding of surgical risk, expectations of recovery, and adherence to appropriate postoperative care. Despite their potential importance, such misconceptions remain insufficiently explored, particularly in settings affected by healthcare and educational challenges. This study aimed to assess the prevalence of common misconceptions regarding postoperative complications among surgical patients in Aleppo, Syria, and to explore their associations with selected sociodemographic and clinical characteristics. A cross-sectional study was conducted among 306 surgical patients at two major surgical centers in Aleppo, Syria, between December 30, 2025, and February 1, 2026. Data were collected through face-to-face interviews using a structured questionnaire developed specifically for this study. The questionnaire included demographic and clinical characteristics, an open-ended question assessing participants’ ability to identify surgical complications, and 10 Likert-scale statements addressing common misconceptions about postoperative complications. The questionnaire was pilot-tested among 50 patients using repeated administration to assess test–retest consistency. For analysis, endorsement of each misconception was defined as selecting “agree” or “strongly agree.” Spearman’s rank correlation was used to assess associations between misconception responses and selected variables, while multivariable binary logistic regression was performed to examine associations after adjustment for age, education, residence, and sex. Odds ratios (ORs) with 95% confidence intervals (CIs) were reported. The Benjamini–Hochberg procedure was applied to control the false discovery rate across multiple comparisons. Misconceptions were common among participants, with the highest endorsement observed for the belief that strict adherence to postoperative care guarantees prevention of all complications (223/306, 72.9%), followed by the belief that a skilled surgeon guarantees a complication-free outcome (187/306, 61.1%) and that anesthesia is very likely to cause complications (168/306, 54.9%). Nearly half of participants endorsed the belief that non-medical factors may affect recovery or cause complications (145/306, 47.4%). In the correlation analysis, higher educational attainment showed weak inverse associations with selected misconceptions, including the belief that the absence of inpatient adverse events excludes later complications (ρ = −0.196, q = 0.006) and the belief that non-medical factors may affect recovery or cause complications (ρ = −0.165, q = 0.019). Emergency surgical status was also weakly inversely associated with the belief that anesthesia is very likely to cause complications (ρ = −0.190, q = 0.008). None of the associations identified in the multivariable logistic regression remained statistically significant after false discovery rate correction. The open-ended question further showed that 39.8% of participants were unable to identify any surgical complication. Misconceptions regarding postoperative complications were frequent among surgical patients in this study, particularly concerning the perceived ability of postoperative adherence, surgeon skill, and anesthesia-related factors to determine surgical outcomes. Although weak associations with educational attainment and emergency surgical status remained statistically significant after correction for multiple comparisons, their small effect sizes do not support interpreting these factors as strong or clinically meaningful predictors. These findings highlight the need for clear, accessible, and context-appropriate patient education that emphasizes the multifactorial nature of surgical complications, expected recovery, and warning signs requiring medical attention.