Preoperative Anxiety and Its Associated Factors Among Patients Undergoing Elective Surgery at a Tertiary Care Hospital: A Cross-Sectional Study.

Background: Preoperative anxiety is a frequent psychological response to impending anaesthesia and surgery. When substantial, it can interfere with perioperative communication, increase distress, alter pain perception, and negatively influence the overall surgical experience. Objectives: To determine the prevalence and severity of preoperative anxiety among adults undergoing elective surgery and to identify demographic, clinical, and perioperative factors associated with clinically relevant anxiety. Methods: This hospital-based cross-sectional study included 100 adults scheduled for elective surgery at Government Medical College and General Hospital, Bhadradri Kothagudem, Telangana, India, from August 2025 to March 2026. Preoperative anxiety and information needs were assessed using the Amsterdam Preoperative Anxiety and Information Scale. An anxiety score of at least 11 defined clinically relevant anxiety. Associations were evaluated using Chi-square and Fisher’s exact tests and multivariable binary logistic regression. Results: The mean age was 47.6 ± 14.2 years, and 54.0% were male. Clinically relevant anxiety was present in 58.0% of participants. Among anxious patients, 41.4% had mild, 37.9% moderate, and 20.7% severe anxiety. Fear of postoperative pain was the leading concern (62.0%), followed by surgical complications (55.0%) and anaesthesia (47.0%). Female sex, absence of previous surgical experience, inadequate preoperative information, waiting longer than four hours, and sleep disturbance independently predicted anxiety. Sleep disturbance showed the strongest association (adjusted odds ratio 3.36; 95% confidence interval 1.35–8.34). Conclusion: Preoperative anxiety affected more than half of adults awaiting elective surgery. Several associated factors were identifiable during routine preoperative assessment. Recommendations: Routine anxiety screening, individualized counselling, clearer perioperative information, better operating-list communication, reduction of unnecessary waiting, and focused support for patients reporting sleep disturbance or first-time surgical exposure should be integrated into preoperative care.