Cohort analysis of relevant factors for negative emotions during the perioperative period in choledocholithiasis patients treated with ERCP and the impact on prognosis

BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is an emerging option in the management of common bile duct stones and has a high success rate for biliary stone extraction. However, due to the lack of knowledge and understanding of this technique, some patients often experience varying degrees of anxiety and depression. There is little research on the factors associated with negative emotions. This study aimed to investigate the risk factors for negative emotions in choledocholithiasis patients treated with ERCP and the impact on prognosis to provide a reference for improving patients’ prognosis. METHODS: We analyzed the data of 364 patients with choledocholithiasis treated with ERCP at our hospital between July 2019 and June 2022. Patients’ emotional state was assessed using the SAS and SDS scales. The t-test and chi-square test were used to analyze the relationship between patients’ negative emotions and prognosis. The patient’s prognosis was assessed at one month postoperatively using the SF-36 scale. Binary logistic regression and multiple linear regression were used to analyze the independent risk factors for negative emotions and prognosis in patients. RESULTS: In this study, the prevalence of anxiety was 10.4%, the prevalence of depression was 8.8% and the prevalence of negative emotions was 15.4%. Binary logistic regression analysis showed that gender [odds ratio (OR) =0.379, P=0.023], fertility status (OR =0.164, P=0.032), monthly household income (OR =0.180, P=0.001) and so on were independent risk factors for the anxiety. Fertility status (OR =0.173, P=0.038), marital status (OR =0.210, P=0.043), TBIL on the first postoperative day (OR =1.079, P=0.002) and so on were independent risk factors for depression. Multiple linear regression analysis revealed that the presence of negative emotions (P=0.001) was an important risk factor for prognosis. CONCLUSIONS: Patients with choledocholithiasis treated with ERCP are prone to anxiety, depression and other psychological disorders. Therefore, clinical work should not only focus on the patient’s condition, but also pay attention to the patient's family situation and emotional changes, and give timely psychological counselling and prevent complications, reduce the patient’s suffering and improve the patient’s prognosis.