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Consequences of the prolonged waiting time for patient candidates for heart surgery
Nagib Haddad1, Olímpio J N V Bittar, Ana A M Pereira
1Instituto Dante Pazzanese de Cardiologia, Saúde do Estado de São Paulo.
Insights
High mortality rates and significant psychological distress affect patients awaiting heart surgery, particularly those with valvular heart disease. Prolonged waiting times negatively impact mental health and social well-being.
Area of Science:
- Cardiology
- Psychology
- Public Health
Background:
- Prolonged waiting times for cardiac surgery are a growing concern.
- The impact on patient mortality and psychological well-being requires thorough investigation.
Purpose of the Study:
- To evaluate mortality rates associated with waiting for heart surgery.
- To assess the psychological repercussions of extended surgical waiting lists.
Main Methods:
- A cohort of 484 coronary heart disease, 121 valvular heart disease, and 100 congenital heart disease patients were interviewed.
- Standardized questionnaires and semi-structured psychological interviews were employed.
- Data collection occurred between July 1999 and May 2000.
Main Results:
- Mortality rates per 100 patient-years were 5.6 (coronary), 12.8 (valvular), and 3.1 (congenital).
- Patients with valvular heart disease exhibited lower survival rates and a higher probability of not undergoing surgery, especially females.
- Significant anxiety and adaptive difficulties were reported by patients awaiting surgery.
Conclusions:
- High mortality rates were observed, with valvular heart disease patients facing the greatest risk.
- Extended waiting periods for heart surgery lead to adverse psychological and social outcomes.
Objective:
To assess mortality and the psychological repercussions of the prolonged waiting time for candidates for heart surgery.
Methods:
From July 1999 to May 2000, using a standardized questionnaire, we carried out standardized interviews and semi-structured psychological interviews with 484 patients with coronary heart disease, 121 patients with valvular heart diseases, and 100 patients with congenital heart diseases.
Results:
The coefficients of mortality (deaths per 100 patients/year) were as follows: patients with coronary heart disease, 5.6; patients with valvular heart diseases, 12.8; and patients with congenital heart diseases, 3.1 (p<0.0001). The survival curve was lower in patients with valvular heart diseases than in patients with coronary heart disease and congenital heart diseases (p<0.001). The accumulated probability of not undergoing surgery was higher in patients with valvular heart diseases than in the other patients (p<0.001), and, among the patients with valvular heart diseases, this probability was higher in females than in males (p<0.01). Several patients experienced intense anxiety and attributed their adaptive problems in the scope of love, professional, and social lives, to not undergoing surgery.
Conclusion:
Mortality was high, and even higher among the patients with valvular heart diseases, with negative psychological and social repercussions.