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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

Decoding Fear: Analysis and Prognosis of Preoperatory Stress Level Through Advanced Statistical Modelling—A Prospective Study Across Multiple Surgical Specialties †

by
Cristina Gena Dascălu
1,
Andrei Ionut Cucu
2,*,
Andreea Vovciuc
2,
Sorin Axinte
2,3,
Serban Turliuc
4,
Amelian Madalin Bobu
4,5,
Camelia Tamas
4,5,
Vlad Porumb
4,
Emilia Patrascanu
4,
Catalin Mihai Buzduga
4,5,
Paula Alexandra Blanaru
4,
Anca Petruta Morosan
4,5,
Iulian Prutianu
4,
Roxana Covali
6,
Andreea Ioana Pruteanu
4,
Claudia Florida Costea
4 and
Alexandru Carauleanu
4
1
Department of Medical Informatics and Biostatistics, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 University Street, 700115 Iasi, Romania
2
Faculty of Medicine and Biological Sciences, University Stefan cel Mare of Suceava, 720229 Suceava, Romania
3
Suceava County Emergency Clinical Hospital, 720237 Suceava, Romania
4
Faculty of Medicine, University of Medicine and Pharmacy Grigore T. Popa Iasi, 700115 Iasi, Romania
5
Clinical Emergency Hospital St. Spiridon, 700111 Iasi, Romania
6
Faculty of Medical Bioengineering, University of Medicine and Pharmacy Grigore T. Popa Iasi, 700115 Iasi, Romania
*
Author to whom correspondence should be addressed.
†
“For it is not death or pain that is to be feared, but the fear of pain or death.” (Epictetus).
Med. Sci. 2025, 13(3), 181; https://doi.org/10.3390/medsci13030181
Submission received: 10 August 2025 / Revised: 2 September 2025 / Accepted: 4 September 2025 / Published: 5 September 2025
Review Reports Versions Notes

Abstract

Background: Preoperative stress is a multifactorial phenomenon shaped by physiological, psychological, and social influences, with a substantial impact on postoperative recovery. This study aimed to quantify preoperative stress levels, identify associated factors, and rank their predictive importance. Methods: A prospective study was conducted on 197 patients scheduled for general surgery, orthopedics, neurosurgery, or otorhinolaryngology procedures between December 2024 and June 2025 at Suceava County Emergency Clinical Hospital. Stress levels were assessed using the Brief Measure of Emotional Preoperative Stress (B-MEPS), translated and culturally adapted into Romanian. Statistical analyses included nonparametric tests, generalized linear modeling, and Random Forest regression. Results: The mean B-MEPS score was 21.42 ± 6.04 (range: 11–34), indicating a moderate level of preoperative stress. Higher stress scores were significantly associated with female sex (p < 0.001), lower educational attainment (p = 0.003), divorced marital status (p = 0.007), a history of cancer (p = 0.002), and the type of surgical intervention (p = 0.003). Random Forest analysis identified the type of surgery, educational level, and sex as the strongest predictors. Conclusions: Preoperative stress is chiefly influenced by the type of surgical procedure, educational level, and sex, with potential synergistic effects among these factors. Early identification of high-risk patients enables targeted, personalized interventions to mitigate anxiety and improve perioperative outcomes. Further research should include formal validation of the Romanian version of B-MEPS and the integration of additional psychosocial variables.
Keywords: preoperative stress; B-MEPS; surgery; predictors; random forest; anxiety preoperative stress; B-MEPS; surgery; predictors; random forest; anxiety

Share and Cite

MDPI and ACS Style

Dascălu, C.G.; Cucu, A.I.; Vovciuc, A.; Axinte, S.; Turliuc, S.; Bobu, A.M.; Tamas, C.; Porumb, V.; Patrascanu, E.; Buzduga, C.M.; et al. Decoding Fear: Analysis and Prognosis of Preoperatory Stress Level Through Advanced Statistical Modelling—A Prospective Study Across Multiple Surgical Specialties. Med. Sci. 2025, 13, 181. https://doi.org/10.3390/medsci13030181

AMA Style

Dascălu CG, Cucu AI, Vovciuc A, Axinte S, Turliuc S, Bobu AM, Tamas C, Porumb V, Patrascanu E, Buzduga CM, et al. Decoding Fear: Analysis and Prognosis of Preoperatory Stress Level Through Advanced Statistical Modelling—A Prospective Study Across Multiple Surgical Specialties. Medical Sciences. 2025; 13(3):181. https://doi.org/10.3390/medsci13030181

Chicago/Turabian Style

Dascălu, Cristina Gena, Andrei Ionut Cucu, Andreea Vovciuc, Sorin Axinte, Serban Turliuc, Amelian Madalin Bobu, Camelia Tamas, Vlad Porumb, Emilia Patrascanu, Catalin Mihai Buzduga, and et al. 2025. "Decoding Fear: Analysis and Prognosis of Preoperatory Stress Level Through Advanced Statistical Modelling—A Prospective Study Across Multiple Surgical Specialties" Medical Sciences 13, no. 3: 181. https://doi.org/10.3390/medsci13030181

APA Style

Dascălu, C. G., Cucu, A. I., Vovciuc, A., Axinte, S., Turliuc, S., Bobu, A. M., Tamas, C., Porumb, V., Patrascanu, E., Buzduga, C. M., Blanaru, P. A., Morosan, A. P., Prutianu, I., Covali, R., Pruteanu, A. I., Costea, C. F., & Carauleanu, A. (2025). Decoding Fear: Analysis and Prognosis of Preoperatory Stress Level Through Advanced Statistical Modelling—A Prospective Study Across Multiple Surgical Specialties. Medical Sciences, 13(3), 181. https://doi.org/10.3390/medsci13030181

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