The following is a summary of “Analysis of Factors Contributing to Perioperative Mohs Micrographic Surgery Anxiety: Patient Survey Study at an Academic Center” published in the December 2022 issue of Dermatologic Surgery by Kokoska et al.

Patient anxiety measured throughout the pre-and post-operative periods correlate with poorer pain management and quality of life after surgery. Several patient features affect anxiety before Mohs micrographic surgery (MMS), but the relative importance of some of these factors is unclear. Investigate factors impacting perioperative MMS patient anxiety, especially those with contested influence or unclear evidence. Between 2018 and 2020, the authors assessed 145 adults who had MMS performed by a single MMS surgeon. 

Patients’ demographics, medical history, and anxiety levels were all evaluated on a self-reported 10-point visual analog scale. Health care provider (HCP)–perceived anxiety evaluations were queried. Iterative multiple regression modeling was utilized to delve into the possible causes. Significant predictors of pre-MMS anxiety included younger age, female sex, and self-reported history of anxiety validated by prior HCP diagnosis. Postoperative anxiety rose with more layers removed and higher pre-MMS anxiety. 

Younger patients, more layers removed, prior skin cancer excision, and HCP-perceived pre-MMS anxiety all contributed to higher patient anxiety, as did the number of layers remaining after surgery. Anxiety-reducing therapies should target young female patients with a history of HCP-diagnosed anxiety and patients with more layers removed. Prior skin cancer removal is associated with greater HCP-perceived intraoperative patient anxiety; however, it is not significant for patient-reported anxiety. Anxiety reduction with pre-MMS consultation is questionable.