71 Predictors of children anxiety and association with parental anxiety in the preoperative setting at a tertiary pediatric center

Background Preoperative anxiety is a prevalent phenomenon in the pediatric population. The impact of anxiety can be seen in the children and accompanying family and have significant consequences during anesthesia, the perioperative and postoperative period. Previous studies examining risk factors of anxiety were contradictory and a few studied children aged under 5. Objectives The aim of this study is to evaluate the association between parental anxiety and child anxiety in patients undergoing elective surgery in a tertiary pediatric center. The secondary objectives were to identify the cohort characteristics and the risk factors associated with higher anxiety. Design/Methods In this prospective cohort study, 166 children aged from 2 to 12 years old, who had a surgery between March and June 2019, were analyzed. Children’s anxiety at induction was assessed by the anesthesiologist with the Modified Yale Preoperative Scale Short form (mYPAS-SF). Anxiety level of children over 8 years old was self-assessed by the State-Trait Anxiety Inventory-Child form (STAIC) during the preoperative evaluation. Parents’ anxiety was measured with the State-Trait Anxiety Inventory form (STAI). Data recorded included personal, familial and sociodemographic details, past healthcare history and prior separations. Unadjusted and adjusted logistic regression were performed to identify possible risk factors of children’s anxiety and association between child and parent anxiety. Results The prevalence of significant anxiety at induction was 39.8%. No significant association was observed between the level of anxiety of parents compared to their children except in the group of children aged over 8. In this population, statistically significant correlation was observed between the STAIC and the STAI score, with a Pearson coefficient of 0.4. Children aged 2 to 5 years old and parents aged 15 to 35 years old, being an only child and no anterior history of separation were all associated with higher anxiety at induction. In the adjusted analysis, being five years or older was a protective factor (OR 0.23, 95% CI 0.12;0.45, p<0.001). Conclusion Parent anxiety does not seem to be a good indicator of children’s anxiety even if an association was observed in the group of 8 to 12 years old. Children under 5 are more at risk of preoperative anxiety and could benefit from new technologies and preparative strategies to lower their anxiety level. Anxiety at induction remains difficult to predict and more studies on the subject need to be carried out.