#66 Long-term mental health outcomes of pediatric surgery patients
Marise Svistovski, University of Manitoba; Caroline Piotrowski, University of Manitoba; Laurence Katz, University of Manitoba; Richard Keijzer, University of Manitoba; Sarvesh Logsetty, University of Manitoba; Shahin Shooshtari, University of Manitoba
Children may be particularly vulnerable to trauma caused by medical procedures. Some studies show that trauma symptoms, depression, and anxiety follow surgery in some pediatric patients. Because adverse events in childhood are linked to mental health problems later in life, surgery might have long-lasting effects in pediatric patients. The present review investigates the relationship between surgery in childhood and future symptoms of trauma, depression, and anxiety.
Pubmed was searched for studies discussing these outcomes postoperatively in children aged 4 to 18 years. A total of 24 studies met the inclusion criteria. Of these, 13 had a long-term follow-up period, defined as two years or more postoperatively. A qualitative literature review and an analysis of the included studies were undertaken following the PRISMA guidelines.
Generally, depression and anxiety levels were high up to a year after surgery then tended to improve over time. Trauma symptoms were detected in both short- and long-term studies. These tended to persist. A patient’s postoperative health status was sometimes associated with their mental health. Preoperative mental health was a predictor for postoperative trauma symptoms, depression, and anxiety, as was parental mental health.
Surgery can be a traumatic experience for children, and mental health consequences can persist into adulthood. The findings of this review indicate that, in some children, long-lasting trauma follows surgical procedures. Depression and anxiety did not appear to last beyond the follow-up periods of these studies. More long-term research is needed to provide information to allow healthcare workers to better identify those at risk for adverse mental health effects and provide the support needed.