Patterns of patient worry following major emergency abdominal surgery: a 180-day follow-up study

Purpose Major emergency abdominal surgery is associated with high postoperative morbidity and mortality. Beyond physical complications, patients experience psychological distress. This study aimed to describe the distribution of patient-reported worry across independent cross-sectional samples and its association with Days Alive and out of Hospital (DAOH) over 180 days postoperatively. Methods Prospective cohort at Copenhagen University Hospital Herlev (March 30, 2023–March 31, 2024). Degree of Worry (DOW) was surveyed at discharge and postoperative day (POD) 30, 90, and 180, categorized as physical, mental, and physical-generic domains of worry. DAOH was computed cumulatively and incrementally for 0–30, 30–90, and 90–180 days. Associations between high DOW (hDOW) and subsequent DAOH were tested with Mann–Whitney U. Results hDOW was reported by 36.1% at discharge, 22.4% at POD 30, 45.0% at POD 90, and 32.0% at POD 180. Across 180 days, the most frequent worries were relapse (21.3%), disease (14.1%), functional level (12.0%) and daily living (9.1%). The proportion of physical worries was significantly higher at POD 30 than at discharge and significantly lower at POD 180; mental worries varied between time points without statistically significant differences. hDOW at POD 30 was associated with fewer cumulative DAOH by POD 90 ( p = 0.008). Conclusion Patient-reported worry following major emergency abdominal surgery demonstrates meaningful variation over time. Physical worries peak during early recovery, whereas mental worry varied across timepoints. hDOW at POD 30 is associated with reduced DAOH by POD 90, highlighting the relevance of monitoring patient-reported worry during early postoperative recovery.