Analysis of Risk Factors for Negative Emotions in the Perioperative Period in Patients with Benign Ovarian Cysts Treated Laparoscopically and Their Impact on Prognosis: A Retrospective Cohort Study

Figures & data

Figure 1 Flow chart of patient selection.

Table 1 SAS and SDS Scores in Patients with Benign Ovarian Cysts

Item	N(%)	SAS (Mean±SD)	t	P	SDS (Mean±SD)	t	P
Age(year)
<40	225(73.1)	44.18±6.63	−1.027	0.305	46.90±6.86	−2.100	0.037
≥40	83(26.9)	43.35±5.21			45.13±5.58
BMI (kg/m^2)
<24	176(57.1)	44.43±6.52	1.544	0.124	46.56±6.37	0.432	0.666
≥24	132(42.9)	43.32±5.90			46.23±6.88
Fertility or not
Have children	260(84.4)	43.37±5.70	3.059	0.003	46.02±6.30	2.497	0.013
No children	48(15.6)	47.13±8.15			48.58±7.65
Spouse or not
Have spouse	250(81.2)	43.61±5.87	1.998	0.047	45.85±6.26	3.227	0.001
No spouse	58(18.8)	45.43±7.68			48.90±7.38
Address
Countryside	75(24.4)	43.57±5.81	−0.604	0.546	46.60±7.44	0.269	0.788
City	233(75.6)	44.08±6.43			46.36±6.30
Education level
High School and below	122(39.6)	44.11±6.25	0.362	0.717	46.70±6.99	0.593	0.554
High School or above	186(60.4)	43.85±6.31			46.24±6.31
Monthly household income (yuan)
<5000	81(26.3)	46.27±6.98	3.960	0.000	48.06±6.95	2.637	0.009
≥5000	227(73.7)	43.13±5.80			45.84±6.36
Basic diseases
Yes	69(22.4)	45.19±5.90	−1.861	0.064	47.96±5.95	−2.212	0.028
No	239(77.6)	43.60±6.35			45.98±6.70
Age of menarche
<13	133(43.2)	43.76±6.22	−0.475	0.635	47.08±6.74	1.522	0.129
≥13	175(56.8)	44.10±6.34			45.93±6.43
Maximum diameter of cyst
<5 cm	250(81.2)	43.57±6.04	−2.234	0.026	46.16±6.09	−1.216	0.228
≥5 cm	58(18.8)	45.60±7.03			47.57±8.35
Cyst site
Unilateral	217(70.5)	43.45±6.08	−2.184	0.030	45.89±6.87	−2.188	0.029
Bilateral	91(29.5)	45.15±6.60			47.68±5.69
Pelvic adhesions
Yes	87(28.2)	44.83±7.11	−1.535	0.126	48.00±7.57	−2.666	0.008
No	221(71.8)	43.61±5.90			45.80±6.05
Course of disease (year)
<2	129(41.9)	43.27±6.17	−1.626	0.105	46.25±6.99	−0.393	0.694
≥2	179(58.1)	44.45±6.33			46.55±6.29
Menstrual status
Regular	105(34.1)	42.99±5.30	−2.094	0.037	45.02±5.90	−2.719	0.007
Irregular	203(65.9)	44.45±6.69			47.15±6.81

Abbreviations: BMI, Body mass index; SAS, Self-Rating Anxiety Scale; SDS, Self-Rating Depression Scale.

Table 2 Perioperative Indicators in Patients with or Without Negative Emotions

Item (Mean±SD)	Intraoperative Bleeding Loss (mL)	Surgery Time (min)	Gastrointestinal Function Recovery Time (d)	Hospitalization Time (d)
With negative emotions	71.04±11.56	103.74±10.99	1.70±0.72	9.72±2.38
Without negative emotions	66.64±8.78	102.98±12.09	1.44±0.62	9.02±2.08
t	−3.005	−0.402	−2.5528	−2.078
P	0.003	0.688	0.011	0.039

Table 3 Inflammatory Indicators in Patients with or Without Negative Emotions

Item (Mean±SD)	PreoperativeCRP (mg/L)	PreoperativeIL-2 (ug/mL)	PreoperativeIL-6 (ng/L)	PreoperativePCT (ug/L)
With negative emotions	8.68±2.09	2.52±0.69	20.86±2.62	3.28±0.51
Without negative emotions	8.48±2.27	2.54±0.67	20.69±2.31	3.27±0.53
t	−0.554	0.196	−0.467	−0.158
P	0.580	0.845	0.641	0.875
With negative emotions	16.96±3.48	4.30±0.60	24.83±2.84	4.87±0.81
Without negative emotions	14.98±3.23	4.09±0.46	24.37±2.73	4.61±0.80
t	−3.831	−2.805	−1.054	−2.017
P	0.000	0.005	0.293	0.048

Abbreviations: CRP, C-reactive protein; IL-2, Interleukin 2; IL-6, Interleukin 6; PCT, Procalcitonin.

Table 4 Ovarian Reserve Function Indicators in Patients with or Without Negative Emotions

Item (Mean±SD)	Preoperative FSH (mIU/mL)	Preoperative LH (mIU/mL)	Preoperative E2 (pmol/L)	Preoperative AMH (ng/mL)
With negative emotions	5.53±0.63	6.48±1.57	203.77±17.50	5.67±0.55
Without negative emotions	5.51±0.60	6.21±1.40	201.12±17.06	5.62±0.55
t	−0.171	−1.202	−0.978	−0.596
P	0.865	0.230	0.329	0.551
With negative emotions	11.26±1.24	10.86±1.89	175.20±17.02	3.79±0.68
Without negative emotions	10.86±1.16	9.39±2.12	169.26±18.7	3.51±0.53
t	−2.150	−4.508	−2.029	−3.062
P	0.032	0.000	0.043	0.002

Abbreviations: FSH, Follicle stimulating hormone; LH, Luteinizing hormone; E2, Estradiol; AMH, Anti-mullerian hormone.

Table 5 Complications in Patients with or Without Negative Emotions

Item (N, %)	Fever		Abdominal Pain		Infection		Hemorrhage		Abdominal Adhesions		Recurrence
	Yes	No	Yes	No	Yes	No	Yes	No	Yes	No	Yes	No
With negative emotions	5(10.6)	42(89.4)	4(8.5)	43(91.5)	3(6.4)	44(93.6)	0(0.0)	47(100.0)	1(2.1)	46(97.9)	6(12.8)	41(87.2)
Without negative emotions	8(3.1)	253(96.9)	5(1.9)	256(98.1)	3(1.1)	258(98.9)	2(0.8)	259(99.8)	2(0.8)	259(99.2)	11(4.2)	250(95.8)
X^2	5.650		6.107		5.711		0.363		0.765		5.585
P	0.017		0.013		0.017		0.382		0.382		0.018

Table 6 Binary Logistic Regression Analysis of Patients’ Negative Emotion

Related Factor	B	SE	Wald	P	OR	95% CI
						Upper	Lower
Age	0.428	0.500	0.732	0.392	1.534	4.085	0.576
Fertility or not	−1.144	0.551	4.315	0.038	0.319	0.937	0.108
Spouse or not	0.135	0.564	0.057	0.811	1.144	3.456	0.379
Monthly household income	−0.858	0.404	4.516	0.034	0.424	0.935	0.192
Basic diseases	−0.036	0.502	0.005	0.943	0.965	2.583	0.361
Maximum diameter of cyst	1.120	0.439	6.522	0.011	3.066	7.246	1.298
Cyst site	0.360	0.411	0.767	0.381	1.433	3.205	0.641
Pelvic adhesions	1.243	0.402	9.563	0.002	3.466	7.621	1.576
Menstrual status	1.131	0.514	4.849	0.028	3.099	8.481	1.132
Intraoperative bleeding loss	0.042	0.019	4.771	0.029	1.043	1.082	1.004
Gastrointestinal function recovery time	0.623	0.275	5.118	0.024	1.864	3.198	1.087
Hospitalization time	0.133	0.087	2.345	0.126	1.143	1.355	0.963
Fever	2.164	0.684	10.008	0.002	8.708	33.284	2.278
Abdominal pain	2.298	0.869	6.989	0.008	9.959	54.731	1.812
Infection	1.869	1.056	3.133	0.077	6.482	51.348	0.818
Recurrence	1.306	0.657	3.955	0.047	3.691	13.364	1.019

Abbreviations: SE, standard error; OR, odds ratio; CI, confidence interval.

Figure 2 Binary logistic regression analysis of patients’ negative emotion.

Table 7 PQRS in 1 Month After Surgery of Patients in Two Groups

Item (Mean±SD)	Physiological Domain	Nociceptive Domain	Emotive Domain	Activities of Daily Living Domain	Cognitive Domain	Overall Evaluation Domain	Total
With negative emotions	20.47±3.15	7.04±1.22	6.64±1.61	9.11±1.96	19.19±3.08	9.47±2.49	71.91±7.81
Without negative emotions	22.43±3.12	7.15±1.09	7.98±1.12	9.85±1.13	21.45±2.78	11.36±2.48	80.21±6.44
t	3.953	0.609	7.024	3.653	5.040	4.812	7.864
P	0.000	0.543	0.000	0.000	0.000	0.000	0.000

Abbreviation: PQRS, Post-operative quality recovery scale.

Table 8 Linear Logistic Regression Analysis of PQRS Score

Related Factor	B	SE	t	P
Basic diseases	2.977	0.864	3.444	0.001
With negative emotions	−6.625	1.137	−5.825	0.000
Age of menarche	0.091	0.729	0.125	0.901
Maximum diameter of cyst	−2.203	0.968	−2.274	0.024
Cyst site	−2.863	0.782	−3.663	0.000
Pelvic adhesions	−0.171	0.803	−0.214	0.831
Course of disease (year)	−0.593	0.745	−0.796	0.427
Menstrual status	1.187	0.778	1.526	0.128
Fever	0.087	1.804	0.048	0.962
Abdominal pain	−0.592	2.168	−0.273	0.785
Infection	−5.593	2.671	−2.094	0.037
Hemorrhage	−2.446	4.452	−0.549	0.583
Abdominal adhesions	−10.236	3.717	−2.754	0.006
Recurrence	−4.232	1.628	−2.599	0.010
Postoperative CRP (mg/L)	0.111	0.110	1.009	0.314
Preoperative IL-6 (ng/L)	0.180	0.131	1.376	0.170
Preoperative IL-2 (ug/mL)	−1.584	0.747	−2.121	0.035
Preoperative PCT (ug/L)	0.751	0.451	1.666	0.097
Preoperative FSH (mIU/mL)	0.701	0.310	2.257	0.025
Preoperative LH (mIU/mL)	−0.173	0.174	−0.991	0.322
Preoperative E2 (pmol/L)	−0.040	0.020	−2.068	0.040
Preoperative AMH (ng/mL)	−1.299	0.648	−2.004	0.046

Abbreviations: PQRS, Post-operative quality recovery scale; SE, standard error; CRP, C-reactive protein; IL-2, Interleukin 2; IL-6, Interleukin 6; PCT, Procalcitonin; FSH, Follicle stimulating hormone; LH, Luteinizing hormone; E2, Estradiol; AMH, Anti-mullerian hormone.