Department of Thoracic and Cardiovascular Surgery, Graduate School of Medicine, Hirosaki University, Japan.
Psychosomatics. 2011 Sep-Oct;52(5):428-32. doi: 10.1016/j.psym.2011.03.010.
Surgical treatment, especially thoracic surgery, is a burdensome prospect for many patients. Depression-related anxiety, insomnia, and stress are common complaints in preoperative patients. Such depressive complaints are currently thought to affect the patients' physiological status. We examined the effect of mental status on the length of hospitalization following thoracic surgery.
The study population was comprised of 52 patients (lung cancer 88%) who underwent operative treatment for thoracic disease. Patient depressive status was evaluated using the Self-Rating Depression Scale (SDS) at admission and again at discharge. Demographic data were collected retrospectively and included age, thoracotomy, and number of days in the hospital.
SDS scores did not differ between admission and discharge (37.7 ± 9.9 vs. 40.4 ± 8.9, respectively; ns). The length of hospitalization in patients with depression (SDS score > 40) was significantly greater than for those without depression (P < 0.05). The length of hospitalization significantly correlated with the SDS score at admission (r = 0.492, P < 0.001). Multiple regression analyses revealed that the length of hospitalization correlated with the SDS score at admission (P < 0.01) and with endoscopic surgery (P < 0.05).
This study suggests that depression increases the length of hospitalization for malignancy patients undergoing thoracic surgery; early intervention or treatment for depression may be required for these patients to improve outcomes.
手术治疗,尤其是胸外科手术,对许多患者来说是一个负担。术前患者常伴有与抑郁相关的焦虑、失眠和压力等问题。目前认为这些抑郁症状会影响患者的生理状态。我们研究了精神状态对胸外科手术后住院时间的影响。
研究对象为 52 例(88%为肺癌)接受胸科疾病手术治疗的患者。入院时和出院时使用自评抑郁量表(SDS)评估患者的抑郁状态。回顾性收集人口统计学数据,包括年龄、开胸手术和住院天数。
SDS 评分在入院时和出院时无差异(分别为 37.7 ± 9.9 和 40.4 ± 8.9,ns)。抑郁患者(SDS 评分>40)的住院时间明显长于无抑郁患者(P < 0.05)。住院时间与入院时 SDS 评分显著相关(r = 0.492,P < 0.001)。多元回归分析显示,住院时间与入院时 SDS 评分(P < 0.01)和内镜手术(P < 0.05)相关。
本研究表明,抑郁会增加接受胸外科手术的恶性肿瘤患者的住院时间;可能需要对这些患者进行早期干预或治疗抑郁,以改善预后。