Korbmacher B, Ulbrich S, Dalyanoglu H, Lichtenberg A, Schipke J D, Franz M, Schäfer R
Clinic for Cardiovascular Surgery, University Hospital Düsseldorf, Düsseldorf, Germany.
Thorac Cardiovasc Surg. 2013 Dec;61(8):676-81. doi: 10.1055/s-0032-1333326. Epub 2013 Jan 23.
The high incidence of symptomatic anxiety and depression in coronary artery bypass graft (CABG) patients may lead to impaired quality of life and increased morbidity and mortality. This prospective longitudinal study on CABG patients should provide data for future preoperative and postoperative psychotherapeutic interventions.
From 2009 to 2010, 135 consecutive patients who were able and prepared were consulted by one interviewer immediately before 1 week (early) and 6 months (late) after surgery to complete the "Hospital Anxiety and Depression Scale" questionnaire.
Compared with the standard population, anxiety scores (AS) were preoperatively elevated in 39.3% of the patients. Early and late after surgery, AS had decreased to 34.4% (not significant [n.s.]) and 28.9% (p < 0.01). Before surgery, depression scores (DS) were elevated in 20.7%. Early and late after surgery, DS further increased to 24.0% (n.s.) and 28.0% (n.s.).Preoperative elevated DS appeared to correlate with increased complications. Mortality was not associated with elevated AS or DS. Both scores were not affected by on- or off-pump surgery.
Remarkably high AS and elevated DS late postoperatively require psychotherapeutic support even after seemingly successful CABG.
冠状动脉搭桥术（CABG）患者中症状性焦虑和抑郁的高发生率可能导致生活质量受损以及发病率和死亡率增加。这项针对CABG患者的前瞻性纵向研究应为未来的术前和术后心理治疗干预提供数据。
2009年至2010年，135例有能力且已做好准备的连续患者在手术前1周（早期）和术后6个月（晚期）由一名访谈者进行咨询，以完成“医院焦虑与抑郁量表”问卷。
与标准人群相比，39.3%的患者术前焦虑评分（AS）升高。术后早期和晚期，AS分别降至34.4%（无统计学意义[n.s.]）和28.9%（p<0.01）。术前，20.7%的患者抑郁评分（DS）升高。术后早期和晚期，DS进一步升至24.0%（无统计学意义）和28.0%（无统计学意义）。术前DS升高似乎与并发症增加相关。死亡率与AS或DS升高无关。两种评分均不受体外循环或非体外循环手术的影响。
即使在看似成功的CABG术后，术后晚期仍有相当高的AS和升高的DS，需要心理治疗支持。
