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You have full access to this open access article. Ambulatory surgery patients are at risk of adverse psychological outcomes such as anxiety, aggression, fatigue, and depression. We developed and validated a clinical prediction model to identify patients who were vulnerable to these psychological outcome parameters. Three psychological vulnerability categories were considered—i. The following determinants were assessed preoperatively: sociodemographic age, sex, level of education, employment status, marital status, having children, religion, nationality , medical heart rate and body mass index , and psychological variables self-esteem and self-efficacy , in addition to anxiety, aggression, fatigue, and depression.

A prediction model was constructed using ordinal polytomous logistic regression analysis, and bootstrapping was applied for internal validation. This study identified a substantial group of vulnerable patients in ambulatory surgery. The proposed clinical prediction model could allow healthcare professionals the opportunity to identify vulnerable patients in ambulatory surgery, although additional modification and validation are needed.

Ambulatory surgery is increasing in the Western world in parallel with improved surgical safety due to advancements in anesthesia and surgical techniques.

Perioperative morbidity and mortality in adult ambulatory surgery is less than 0. Nevertheless, poor psychological outcomes in patients can have negative socioeconomic consequences due to prolonged convalescence that delays a return to normal activities and work.