The Relationship Between Preoperative Anxiety, Postoperative Pain, and Kinesiophobia in Patients Undergoing Cardiac Surgery: A Prospective Observational Study

We examined associations between preoperative anxiety and postoperative pain and kinesiophobia. This single-center study included 120 patients (coronary-artery bypass grafting [CABG], n = 85; valve surgery, n = 35). State and trait anxiety were assessed preoperatively. Pain-related outcomes and kinesiophobia were assessed at three perioperative time points. Surgery-specific correlations underwent false discovery rate adjustment. In the full cohort, state anxiety (rho = −0.134, p = 0.145) and trait anxiety (rho = 0.017, p = 0.856) were not significantly correlated with the postoperative pain-related composite; corresponding postoperative kinesiophobia correlations were rho = 0.025 (p = 0.783) and rho = −0.063 (p = 0.495). The nine-item pain-related composite increased postoperatively (4.57 ± 0.40 to 7.50 ± 0.30) and declined predischarge (4.53 ± 0.37; Friedman p < 0.001; Kendall W = 0.766, reported as the effect-size measure for the Friedman test); kinesiophobia remained stable (p = 0.796). In exploratory analyses, state anxiety correlated with postoperative composite scores in valve surgery (rho = −0.409, p = 0.015) and predischarge kinesiophobia in CABG patients (rho = 0.230, p = 0.034); neither survived multiplicity adjustment (q = 0.234 and 0.276). Overall associations were not statistically significant; exploratory subgroup signals require confirmation in adequately powered, procedure-specific studies.