Preoperative Treatment Expectations and Their Association with Postoperative Quality of Life and Patient Satisfaction in Non-Orthopedic Surgery: A Systematic Review

Background: Patients’ preoperative expectations may influence postoperative quality of life and satisfaction. Aim: To provide an overview of the evidence regarding the association between patients’ preoperative expectations and postoperative quality of life as the primary outcome, with postoperative satisfaction included as a secondary outcome. Methods: A systematic review was conducted in accordance with the PRISMA guidelines and Cochrane Handbook of Systematic Reviews guidelines. A comprehensive search was conducted across five databases for all study types. Results: Ten cohort studies met the inclusion criteria, encompassing 1013 patients undergoing various surgical procedures. Most studies exhibited a high risk of bias, and several employed unvalidated instruments to assess preoperative expectations. Only one study found a significant association between preoperative expectations and quality of life. One study reported significantly better perceived health among patients with high preoperative expectations, and four studies identified a significant relationship between preoperative expectations and post-operative satisfaction. Overall, the findings were inconsistent, and the included studies demonstrated substantial methodological heterogeneity. Conclusions: Only individual studies identified significant associations with quality of life, perceived health, or postoperative satisfaction; overall, the findings were inconsistent. The evidence is limited by high risk of bias, heterogeneous methodologies, and use of non-validated measurement tools. Further research is needed to clarify the role preoperative expectations have in postoperative outcomes.