Faria Joana, Gomes Maria, Costa Gabriela, Marinho Ana, Gomes Diana, Lima Fátima
Departamentos de Anestesiologia do Centro Hospitalar do Tâmega e Sousa, Penafiel, do Centro Hospitalar do Alto Ave, Guimarães e do Centro Hospitalar de Vila Nova de Gaia/Espinho, Portugal.
Rev Port Cir Cardiotorac Vasc. 2014 Jan-Mar;21(1):31-5.
Cardiac surgery may account for long term complications as depression. Geriatric Depression Scale (GDS) is a reliable 30-item questionnaire for assessing depressive symptoms in several populations. The aim of the present study was to determine the prevalence and predictors of depression after open-heart valve replacement surgery in a portuguese population.
Prospective observational study enrolling 52 patients (55.8% men, mean age 67.7 ± 11.3 years) with no history of depression, submitted to elective open-heart valve replacement surgery. Patients completed the GDS questionnaire at 6-month follow-up. Cardiovascular risk factors, medical history, left ventricular function, prescription table, analytical and surgical variables and length of hospital stay were collected to verify its influence on postoperative depression.
Twenty-seven patients (41.4% men, mean age 69.3 ± 10.3 years) had scores consistent with symptoms of depression (GDS score >10), representing 51.9% of the sample. Twenty-one (77.8%) were mildly depressed, 6 (22.2%) were severely depressed and only 4 (19.0%) and 3 (50.0%) were on antidepressants, respectively. Postoperative complications (29.6 vs 8.0%, p=0.045), lower postoperative hemoglobin concentration (8.9 ± 0.8 vs 9.8 ± 1.5 g/dL p=0.015) and longer time of hospitalization (12.2 ± 7.7 vs 8.2 ± 3.4 days, p=0.020) were found to be significant predictors for postoperative depression. No other statistically significant differences were found.
Depression after open-heart valve replacement surgery is frequent but appears to be generally overlooked. Strategies for systematic screening and early guidance should be implemented to ensure better health and quality-of-life of patients undergoing major cardiac surgery.
心脏手术可能导致诸如抑郁症等长期并发症。老年抑郁量表（GDS）是一份可靠的包含30个条目的问卷，用于评估多人群中的抑郁症状。本研究的目的是确定葡萄牙人群中接受心脏瓣膜置换手术后抑郁症的患病率及预测因素。
一项前瞻性观察性研究，纳入52例无抑郁症病史的患者（男性占55.8%，平均年龄67.7±11.3岁），接受择期心脏瓣膜置换手术。患者在6个月随访时完成GDS问卷。收集心血管危险因素、病史、左心室功能、用药清单、分析及手术变量以及住院时间，以验证其对术后抑郁的影响。
27例患者（男性占41.4%，平均年龄69.3±10.3岁）的得分与抑郁症状相符（GDS评分>10），占样本的51.9%。其中21例（77.8%）为轻度抑郁，6例（22.2%）为重度抑郁，仅有4例（19.0%）和3例（50.0%）分别正在服用抗抑郁药。术后并发症（29.6%对8.0%，p=0.045）、术后血红蛋白浓度较低（8.9±0.8对9.8±1.5 g/dL，p=0.015）以及住院时间较长（12.2±7.7对8.2±3.4天，p=0.020）被发现是术后抑郁的显著预测因素。未发现其他具有统计学意义的差异。
心脏瓣膜置换手术后抑郁症很常见，但似乎普遍被忽视。应实施系统筛查和早期指导策略，以确保接受心脏大手术患者的健康状况和生活质量得到改善。
