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Depression before and after cardiac surgery: do all patients respond the same?
David Horne1, Scott Kehler, George Kaoukis
1Department of Surgery (Cardiac Surgery), University of Manitoba, Winnipeg, Manitoba, Canada. drhorne@shaw.ca
The Journal of Thoracic and Cardiovascular Surgery
|December 25, 2012
Summary
Depression affects nearly 40% of cardiac surgery patients by discharge, with preoperative depression being a key risk factor. New cases of depression are common post-surgery, highlighting the need for proactive mental health screening.
Area of Science:
- Cardiology
- Psychiatry
- Public Health
Background:
- Depression is a significant concern in patients undergoing cardiac surgery.
- Understanding the trajectory of depression before and after surgery is crucial for patient outcomes.
Purpose of the Study:
- To determine the prevalence, incidence, and risk factors for depression in patients before and after cardiac surgery.
- To identify predictors of postoperative depression.
Main Methods:
- A cohort of 436 patients awaiting non-emergent cardiac surgery completed depression and physical activity questionnaires preoperatively and at discharge.
- Patients were categorized based on depression severity (naïve, at-risk, depressed).
- Multivariate logistic regression identified factors associated with depression.
Main Results:
- Depression prevalence increased from 23.6% preoperatively to 37.7% at discharge.
- The incidence of new-onset depression at discharge was 29.2%.
- Preoperative depression, being at-risk, physical inactivity, and prolonged hospital stay (>7 days) were associated with postoperative depression.
Conclusions:
- Depression is highly prevalent in cardiac surgery patients at discharge.
- Preoperative depression status is the strongest predictor of postoperative depression.
- While most operative factors were not linked to depression, prolonged hospital stay emerged as a risk factor.
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