Effects of Patients' Affect on Adverse Procedural Events during Image-Guided Interventions.

ABSTRACT

PURPOSE: To assess how a patient's affect on presentation relates to the likelihood of adverse events during their subsequent interventional image-guided procedures. MATERIALS AND METHODS: A secondary analysis was performed of an existing dataset from a clinical trial with 230 patients who underwent percutaneous peripheral vascular and renal interventions and who had completed the positive affect (PA) negative affect (NA) schedule (PANAS) before their procedures. Summary PANAS scores were split over the median and used to classify the participants into those with high vs low PA and high vs low NA. Associations between affect and the absence or presence of adverse medical events were examined by two-sided Fisher exact tests. RESULTS: Patients with high baseline NA were significantly more likely to have adverse events during their procedures than those with low baseline NA (18% vs 8%; P = .030). High baseline PA was not associated with a significantly higher frequency of subsequent adverse events compared with low PA (15% vs 9%; P = .23). Patients with high NA requested and received significantly more sedative and opioid agents than those with low NA (2.0 vs 1.0 units requested [P = .0009]; 3.0 vs 1.0 units received [P = .0004]). PA levels did not affect medication use. CONCLUSIONS: High NA, but not PA, was associated with an increased likelihood of adverse events. Improving patients' NA before procedures seems a more suitable target than attempting to boost PA to improve the procedural experience.