Department of Cardiology and Cardiac Surgery, Poriya Medical Center, Tiberias, Israel.
Department of Cardiology and Cardiac Surgery, Poriya Medical Center, Tiberias, Israel; The Academic College at Wingate, Wingate Institute, Netanya, Israel.
Ann Thorac Surg. 2021 Mar;111(3):1064-1070. doi: 10.1016/j.athoracsur.2020.05.130. Epub 2020 Jul 22.
Depression is highly prevalent in cardiac surgical patients and is associated with mortality. The objectives of the study were to evaluate depression scores longitudinally pre- and postoperatively and to examine the association between postoperative depression scores and clinical, surgical, and sociopsychological factors.
Depression scores were assessed using the Center for Epidemiological Study of Depression (CES-D) in 100 cardiac surgical patients who underwent cardiac surgery preoperatively, during hospitalization, and at 2 and 6 week after discharge. Clinical, surgical, and sociopsychological predictors of depression scores were recorded.
The average depression scores significantly increased from preoperative levels (14.9 ± 1.07) to during hospitalization (21.5 ± 1.05) and decreased at both 2 weeks (15.8 ± 1.07) and 6 weeks after discharge (14.0 ± 1.06), as compared with scores during hospitalization (P < .001). The percentage of patients who scored CES-D > 16 increased significantly from preoperative (39%) to hospitalization (71%) and decreased gradually at 2 weeks (45%) and 6 weeks (37%) after discharge (P < .001). Significant predictors of high postoperative CES-D scores were female gender, ejection fraction < 50%, and high preoperative CES-D scores.
High depression scores after cardiac surgery suggest that perioperative screening and management of depression after surgery are necessary and may improve outcomes of these patients who are at high risk for depression. Further understanding of the factors that contribute to high depression scores is required to facilitate clinical intervention.
抑郁在心脏外科患者中普遍存在，与死亡率有关。本研究的目的是评估术前、术后的抑郁评分，并探讨术后抑郁评分与临床、手术和社会心理因素之间的关系。
100 例心脏外科患者在术前、住院期间和出院后 2 周和 6 周使用流行病学研究中心抑郁量表（CES-D）评估抑郁评分。记录临床、手术和社会心理预测因子。
与住院期间相比，平均抑郁评分从术前水平（14.9 ± 1.07）显著升高（21.5 ± 1.05），在出院后 2 周（15.8 ± 1.07）和 6 周（14.0 ± 1.06）时降低（P <.001）。CES-D > 16 的患者比例从术前（39%）到住院期间（71%）显著增加，在出院后 2 周（45%）和 6 周（37%）逐渐降低（P <.001）。术后 CES-D 评分高的显著预测因子为女性、射血分数<50%和术前 CES-D 评分高。
心脏手术后出现高抑郁评分表明，术后有必要对抑郁进行围手术期筛查和管理，这可能改善这些处于高抑郁风险的患者的结局。需要进一步了解导致高抑郁评分的因素，以便促进临床干预。
