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Ann Thorac Surg 2000;70:1789
© 2000 The Society of Thoracic Surgeons

Scientific abstract

Does preoperative depression predict increased late mortality in cardiac surgical patients?

R.A. Baker, PhD, M.J. Andrew, BA, (Hons), G. Schrader, PhD, FRANZCP, J.L. Knight, FRACS

Cardiac Surgical Research Unit, Flinders Medical Centre and Department of Psychiatry, Queen Elizabeth Hospital, Adelaide, Australia

Introduction. There is convincing evidence to suggest that depression significantly increases the risk of mortality after myocardial infarction [1, 2]. The aim of this observational pilot study was to determine whether preoperative depressive symptoms result in an increased risk of mortality after discharge after cardiac surgery.

Methods. Preoperative assessments of depressive symptoms were performed on 158 patients undergoing coronary artery bypass surgery (CABG) with informed consent and institutional approval. Elevated preoperative symptoms of depression were defined as Depression Anxiety Stress Scale score of >=10. Patients were followed for a median of 25 months (range 4 to 38 months).

Results. Twenty-four of the 158 patients (15.2%) were classified as having elevated preoperative depressive symptoms. There were no differences between depressed and nondepressed patients with regard to demographics, clinical risk factors, or surgical parameters. Three of the 24 (12.5%) depressed patients died within the follow-up period, compared with 3 of the 134 (2.2%) nondepressed patients (odds ratio 6.24, 95% CI = 1.18 to 32.98, p = 0.046). There were no differences between the groups with respect to length of intensive care unit or postoperative stay, perioperative myocardial infarction, or 30-day mortality.

Conclusions. Elevated depressive symptoms before CABG may be a significant predictor of late death. Prospective studies evaluating the prevalence of depressive symptoms in cardiac surgical patients and its effect on long-term outcome must be undertaken.

Issues. Depressive symptoms, predictor of mortality.

References

  1. JAMA 1993;270:1819–25.
  2. Circulation 1995;91:999–1005.





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