High incidence of psychological distress before and after major elective noncardiac surgery

One-third of adults experience moderate to severe psychological distress before major elective noncardiac surgery, with 32.6% reporting distress before surgery. This distress tends to persist or worsen over time, with 27.3% experiencing distress at 30 days after surgery and 26.2% at 1 year after surgery. Females and patients undergoing orthopedic procedures show slight improvement, while males and patients undergoing nonorthopedic procedures do not. Younger age, poor self-reported functional capacity, smoking history, and undergoing open surgery are predictors of severe and/or worsened psychological distress.