Proportion and predictors of postoperative depression among elderly urology patients in Bangladesh

BACKGROUND: Postoperative depression is a frequently underdiagnosed condition, particularly in elderly surgical patients, and is associated with poorer recovery outcomes. This study assessed the proportion and risk factors of postoperative depression in elderly patients undergoing urological surgery in Bangladesh. METHODS: A hospital-based cross-sectional study was conducted at a tertiary level hospital in Dhaka, from June to September 2024. A total of 130 patients aged 55 years and above, scheduled for urological surgery, were recruited using systematic sampling. Data were collected preoperatively and at discharge using a structured questionnaire, using the Hospital Anxiety and Depression Scale (HADS). Bivariate and multivariate logistic regression analyses were performed to identify associated risk factors. RESULTS: Postoperative depression was present in 69.2% of patients, with 34.6% experiencing moderate and 2.3% severe symptoms. Significant predictors included age 56–65 years (OR = 3.10, p = 0.024), housewife occupation (OR = 4.48, p = 0.027), sleep problems (OR = 8.16, p = 0.056), surgery duration ≥ 121 min (OR = 13.60, p = 0.025), high pain scores (OR = 0.065, p = 0.023), and perceived stress (OR = 12.82, p = 0.010). Depression was also significantly linked with shorter surgeries, hospital stays over 10 days, functional impairment, and elevated anxiety and stress levels, indicating a strong interplay between psychosocial and surgical factors. CONCLUSION: Our findings demonstrate that anxiety and depression are common among elderly urological patients, highlighting the importance of integrating psychosocial support into routine perioperative care.