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Published on: December 11, 2017

Anxiety predicts mortality and morbidity after coronary artery and valve surgery--a 4-year follow-up study

Andrea Székely1, Piroska Balog, Erzsébet Benkö

  • 1Department of Anesthesia and Intensive Care, Gottsegen György Hungarian Institute of Cardiology, Budapest, Hungary. szekelya@kardio.hu

Psychosomatic Medicine
|August 29, 2007
PubMed

Insights

High preoperative anxiety significantly increases mortality risk in cardiac surgery patients. Ongoing anxiety assessment can help identify those at risk for poor outcomes and cardiovascular events post-surgery.

Area of Science:

  • Cardiology
  • Psychosomatic Medicine
  • Clinical Outcomes Research

Background:

  • Psychosocial factors, particularly anxiety and depression, are increasingly recognized as significant determinants of health outcomes.
  • Previous research on psychosocial factors and cardiac events has primarily focused on population studies or post-myocardial infarction cohorts, leaving a gap in understanding their impact after cardiac surgery.

Purpose of the Study:

  • To investigate the long-term effects of anxiety and depression on patient outcomes following cardiac surgery.
  • To determine if psychological factors can serve as predictors for mortality and cardiovascular events after major cardiac procedures.

Main Methods:

  • A prospective study of 180 patients undergoing cardiac surgery with cardiopulmonary bypass, followed for 4 years.
  • Assessment of anxiety (Spielberger State-Trait Anxiety Inventory, STAI-S/STAI-T) and depression (Beck Depression Inventory, BDI) preoperatively and at multiple time points post-discharge.
  • Clinical endpoints included all-cause mortality and hospitalizations for cardiac events.

Main Results:

  • Elevated preoperative trait anxiety scores (STAI-T >45) were significantly associated with increased mortality (p = .008).
  • Independent predictors of mortality included postoperative congestive heart failure and preoperative trait anxiety.
  • Cardiovascular hospitalizations were independently linked to longer intensive care unit stays and elevated anxiety levels at 6 months post-discharge.

Conclusions:

  • Preoperative and ongoing anxiety assessment are valuable tools for risk stratification in cardiac surgery patients.
  • Identifying patients with high anxiety levels can aid in the early detection of those at higher risk for mortality and cardiovascular morbidity.
  • Integrating psychosocial assessments into routine care may improve patient management and outcomes after cardiac surgery.
Abstract

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