Perioperative Medicine and Intensive Care Function, Karolinska University Hospital, Stockholm, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; Heart and Vascular Theme, Karolinska University Hospital, Stockholm, Sweden.
Heart Lung Circ. 2019 Jun;28(6):953-958. doi: 10.1016/j.hlc.2018.04.298. Epub 2018 May 16.
Depression is common in patients with ischaemic heart disease and preoperative depression is a risk factor following coronary artery bypass grafting. The American Heart Association recommends depression screening in all patients with heart disease. Our aim was to assess the feasibility and results of a depression screening program in cardiac surgery patients.
We introduced a depression screening project at the cardiac surgery department at Karolinska University Hospital and included patients between 2013 and 2016. Patients scheduled for elective surgery recieved the Patient Health Questionnaire (PHQ-9), a depression screening instrument, by mail approximately 2weeks before surgery. Urgent patients recieved the PHQ-9 on the ward. Baseline characteristics, medical history, and medications were collected from patient charts, and entered into a study database together with the results from the PHQ-9 questionaires.
During the study period, 2,512 patients underwent cardiac sugery; 1,133 (45%) completed PHQ-9. The response-rate in patients scheduled for elective surgery was 64%, and 15% in urgent patients. Fifteen per cent (15%) had a PHQ-9 score ≥10 suggestive of major depression. Reporting a PHQ-9 score ≥10 was twice as common in women as in men (23% vs 12%).
Systematic depression screening using PHQ-9 in cardiac surgery patients was feasible and not very resource-intensive. The project showed a satisfactory response-rate in elective patients, but adjustments to increase the response-rate in urgent patients are needed. Future studies should investigate if and how patients with symptoms of depression would benefit from depression management.
抑郁症在缺血性心脏病患者中很常见，术前抑郁症是冠状动脉旁路移植术后的一个危险因素。美国心脏协会建议对所有心脏病患者进行抑郁症筛查。我们的目的是评估心脏手术患者中抑郁症筛查计划的可行性和结果。
我们在卡罗林斯卡大学医院心脏外科部门引入了抑郁症筛查项目，并纳入了 2013 年至 2016 年的患者。择期手术的患者在手术前大约 2 周通过邮件收到了患者健康问卷（PHQ-9），这是一种抑郁症筛查工具。紧急患者在病房接受 PHQ-9 测试。从患者病历中收集基线特征、病史和药物信息，并与 PHQ-9 问卷的结果一起输入研究数据库。
在研究期间，2512 名患者接受了心脏手术；其中 1133 名（45%）完成了 PHQ-9。择期手术患者的回复率为 64%，紧急患者为 15%。15%的患者 PHQ-9 得分≥10，提示有重度抑郁症。报告 PHQ-9 得分≥10 的女性是男性的两倍（23%比 12%）。
在心脏外科患者中使用 PHQ-9 进行系统的抑郁症筛查是可行的，且资源消耗不大。该项目在择期患者中表现出了令人满意的回复率，但需要进行调整以提高紧急患者的回复率。未来的研究应调查有抑郁症状的患者是否以及如何从抑郁管理中受益。
