Perioperative Medicine and Intensive Care Function, Karolinska University Hospital, Stockholm, Sweden; Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden.
Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden.
Intensive Crit Care Nurs. 2020 Aug;59:102851. doi: 10.1016/j.iccn.2020.102851. Epub 2020 Mar 26.
Depression is common in patients with cardiac disease. Depression is a risk factor for developing postoperative delirium, a common and serious complication to cardiac surgery.
The aim was to evaluate if screening tools for depression can be used to predict postoperative delirium after cardiac surgery.
This was a prospective population-based pilot study including 26 patients between 23 and 80 years of age undergoing cardiac surgery in Sweden during 2018. The day before surgery the participants filled out the depression screening instruments Hospital Anxiety and Depression Scale and Patient Health Questionnaire. After discharge the patient charts were examined for documentation of symptoms of delirium.
Five (20%) patients screened positive regarding depression using the Hospital Anxiety and Depression Scale and 7 patients (27%) screened positive using The Patient Health Questionnaire. Four (22%) patients showed symptoms of postoperative delirium, none of them screened positive for depression prior to surgery.
We found no difference between the questionnaires PHQ-9 and HADS regarding identifying depressive symptoms. Moreover, we found that post-operative delirium, to a certain extent, can be detected by reading the patient́s charts postoperatively. However, this pilot study showed that screening tools for delirium need to be better implemented.
心脏病患者中常见抑郁。抑郁是术后谵妄的一个风险因素，而术后谵妄是心脏手术后的一种常见且严重的并发症。
评估抑郁筛查工具是否可用于预测心脏手术后的术后谵妄。
这是一项前瞻性基于人群的试点研究，纳入了 2018 年在瑞典接受心脏手术的 26 名年龄在 23 至 80 岁之间的患者。手术前一天，参与者填写了抑郁筛查工具医院焦虑和抑郁量表和患者健康问卷。出院后，检查患者病历以记录谵妄症状。
使用医院焦虑和抑郁量表有 5 名（20%）患者筛查出抑郁阳性，使用患者健康问卷有 7 名（27%）患者筛查出抑郁阳性。4 名（22%）患者出现术后谵妄症状，术前均未筛查出抑郁。
我们发现 PHQ-9 和 HADS 问卷在识别抑郁症状方面没有差异。此外，我们发现通过术后阅读患者病历可以在一定程度上检测到术后谵妄。然而，这项试点研究表明，需要更好地实施谵妄筛查工具。
