Many surgical patients hold misconceptions about postoperative complications, Syrian study finds

Nearly three-quarters of surgical patients surveyed in Aleppo, Syria, believed that strictly following postoperative care instructions guarantees the prevention of all complications, according to a cross-sectional study of 306 patients at two major surgical centers published in BMC Surgery. The belief that a skilled surgeon guarantees a complication-free outcome was endorsed by 61.1 percent of participants, and 54.9 percent agreed that anesthesia is very likely to cause complications. Nearly half, 47.4 percent, endorsed the idea that non-medical factors may affect recovery or cause complications.

The study, conducted between December 30, 2025, and February 1, 2026, collected data through face-to-face interviews using a structured questionnaire developed specifically for the research. The instrument covered demographic and clinical characteristics, an open-ended question asking participants to identify surgical complications, and ten Likert-scale statements addressing common misconceptions about postoperative complications. Before deployment, the questionnaire was pilot-tested among 50 patients using repeated administration to assess test–retest consistency. For analysis, endorsement of each misconception was defined as selecting “agree” or “strongly agree.”

Beyond the fixed statements, the open-ended question revealed a substantial gap in basic knowledge: 39.8 percent of participants were unable to identify any surgical complication at all. The researchers note that misconceptions about postoperative complications may influence how patients understand surgical risk, what they expect during recovery, and whether they adhere to appropriate postoperative care. Such misconceptions had been insufficiently explored, particularly in settings affected by healthcare and educational challenges, which motivated the study’s focus on Aleppo.

To probe which characteristics were associated with these beliefs, the team used two complementary statistical approaches. Spearman’s rank correlation assessed associations between misconception responses and selected variables, while multivariable binary logistic regression examined associations after adjustment for age, education, residence, and sex. Odds ratios with 95 percent confidence intervals were reported, and the Benjamini–Hochberg procedure was applied to control the false discovery rate across multiple comparisons, a correction that reduces the risk of spurious findings when many associations are tested simultaneously.

In the correlation analysis, higher educational attainment showed weak inverse associations with selected misconceptions, including the belief that the absence of inpatient adverse events excludes later complications (ρ = −0.196, q = 0.006) and the belief that non-medical factors may affect recovery or cause complications (ρ = −0.165, q = 0.019). Emergency surgical status was also weakly inversely associated with the belief that anesthesia is very likely to cause complications (ρ = −0.190, q = 0.008). However, none of the associations identified in the multivariable logistic regression remained statistically significant after false discovery rate correction. The authors caution that although the weak correlations with educational attainment and emergency surgical status remained statistically significant after correction, their small effect sizes do not support interpreting these factors as strong or clinically meaningful predictors.

The study’s design imposes limits on interpretation. As a cross-sectional survey of 306 patients at two surgical centers in a single city, it captures beliefs at one point in time and cannot establish causal relationships between patient characteristics and misconceptions. The questionnaire was newly developed for this study rather than a validated instrument used elsewhere, and the findings reflect the specific healthcare and educational context of Aleppo, so generalization to other settings is uncertain. The article was published as an early-share version, subject to further edits before the final Version of Record.

Despite these constraints, the pattern of results is consistent in direction: misconceptions were frequent, and the most strongly endorsed beliefs centered on the perceived power of postoperative adherence, surgeon skill, and anesthesia-related factors to determine surgical outcomes. In reality, surgical complications arise from multifactorial processes, and no single behavior, provider, or perioperative factor guarantees an outcome in either direction. The finding that a large share of patients could not name any surgical complication adds a knowledge dimension on top of the belief distortions measured by the Likert items.

The authors argue that the findings highlight the need for clear, accessible, and context-appropriate patient education that emphasizes the multifactorial nature of surgical complications, expected recovery, and warning signs requiring medical attention. In practical terms, the results suggest that preoperative and postoperative counseling in similar settings may need to address specific false certainties, such as the guarantee framing of adherence and surgeon skill, rather than simply delivering more information, while also equipping patients to recognize complications that can emerge after discharge.

Subject of Research: Prevalence and determinants of misconceptions about postoperative complications among surgical patients in Aleppo, Syria

Article Title: Prevalence and determinants of misconceptions regarding postoperative complications among surgical patients

Article References: Waez, M., Nahhas, M. A., Al-Yousef, R., Ghazal Habbal, S., Fadel, S., Sereis, A., Karzon, Y., & Ghazal, A. (2026). Prevalence and determinants of misconceptions regarding postoperative complications among surgical patients. BMC Surgery. https://doi.org/10.1186/s12893-026-04281-5

Image Credits: AI Generated

DOI: 10.1186/s12893-026-04281-5

Keywords: surgical patients, postoperative complications, misconceptions, patient education, cross-sectional study, Syria, Aleppo, anesthesia, health literacy, logistic regression, BMC Surgery, Prevalence