Psychosocial factors and surgical outcomes: an evidence-based literature review

J Am Acad Orthop Surg. 2006 Jul;14(7):397-405. doi: 10.5435/00124635-200607000-00002.


The influence of psychosocial factors on clinical outcomes after surgery has been investigated in several studies. This review is limited to surgical outcomes studies published between 1990 and 2004 that include (1) psychosocial variables (eg, depression, social support) as predictors of outcome and that focus on (2) clinical outcomes (eg, postoperative pain, functional recovery) using (3) specific multivariate analytic techniques with (4) relevant clinical variables (eg, presurgical health status) included as covariates. Twenty-nine studies met these criteria. Results indicate that psychosocial factors play a significant role in recovery and are predictive of surgical outcome, even after accounting for known clinical factors. Attitudinal and mood factors were strongly predictive; personality factors were least predictive. The results suggest that preoperative consideration of attitudinal and mood factors will assist the surgeon in estimating both the speed and extent of postoperative recovery.

Publication types

  • Meta-Analysis
  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Affect
  • Anxiety / epidemiology*
  • Anxiety / psychology
  • Attitude to Health*
  • Evidence-Based Medicine
  • Humans
  • Outcome Assessment, Health Care / methods*
  • Psychology*
  • Risk Assessment / methods
  • Risk Factors
  • Stress, Psychological / epidemiology*
  • Stress, Psychological / psychology
  • Surgical Procedures, Operative / psychology*
  • Surgical Procedures, Operative / statistics & numerical data*
  • Treatment Outcome