RSNA 2015: Interventional radiography outcomes can be affected by mood of a patient

Patients who are relaxed and feel positive about an image-guided interventional radiology procedure are more likely to have a better outcome, whereas patients who are hostile, distressed and/or fearful may have a poor outcome. Interventional radiologists need to be alert for patients’ negative attitudes, recommended Nadja Kadom, M.D., in a scientific presentation at RSNA 2015.

Dr. Kadom, a neuroradiologist at Children’s Healthcare of Atlanta and an acting associate professor of radiology Emory University School of Medicine, and colleagues, reported the findings of a study of 230 patients who underwent percutaneous peripheral vascular and renal interventions. The patient cohort had a mean age of 55 years, and included 120 women and 110 men.

All patients completed a Positive Affect Negative Affect Schedule (PANAS), rating 10 adjectives each, reflecting both positive and negative attributes and emotions using a five-point rating scale. Patients were grouped based on high and low scores of the survey for positive affect and high and low scores for negative effect. Those groups were then correlated with the occurrence of adverse events during and following the procedures. Adverse events included prolonged hypoxia, hypertensive or hypotensive episodes, prolonged bradycardia and postoperative bleeding.

Statistical analysis of data revealed that the 104 patients with a high negative affect experienced significantly more adverse effects than the 126 patients with low negative affect. Twenty-two percent of the patients with a high negative affect had an adverse event, compared to 15% who were more positive. The researchers noted that the degree of positive affect did not make a statistically significant difference in the incidence of negative events.

Dr. Kadom noted that while the tendency of the radiology profession is to focus on improving equipment and the techniques to minimize adverse outcomes, there is a growing awareness that patients themselves may make a difference. Co-author and interventional radiologist Elvira V. Lang, M.D., Ph.D., added “Our study shows that mood matters. Although patients are sedated during interventional procedures, they are awake and able to talk with the physician and healthcare team.” In addition to displaying a positive emotional state to a patient, an interventional radiology team needs to know coping strategies to help patients with negative emotions be able to minimize these and reframe their mindsets prior to undergoing a procedure.

“Patients don’t need to have chipper, cheery attitudes prior to their procedure. They do need to overcome negative emotions and get to a neutral level to potentially have a better outcome,” she said.