Department of Health and Social Sciences, Western Norway University of Applied Sciences, Inndalsveien 28, Post Box 7030, 5020, Bergen, Norway.
Centre of Interprofessional Cooperation within Emergency Care (CICE), Linnaeus University, Växjö, Sweden.
Aging Clin Exp Res. 2023 Nov;35(11):2463-2470. doi: 10.1007/s40520-023-02541-5. Epub 2023 Aug 30.
Little is known about mental health following advanced cardiac procedures in the oldest patients.
To study changes in anxiety and depression from baseline to one- and six-month follow-up in older patients following transcatheter aortic valve implantation (TAVI) or surgical aortic valve replacement (SAVR).
Prospective cohort study of patients ≥ 80 years undergoing elective TAVI or SAVR in a tertiary university hospital. Anxiety and depression were assessed with the Hospital Anxiety and Depression Scale. Differences between TAVI/SAVR were analyzed using Welch's t test or chi-squared. Changes over time and group differences were established with longitudinal models using generalized least squares.
In 143 patients (83.5 ± 2.7 years), 46% (n = 65) received TAVI. Anxiety was identified in 11% of TAVI patients at baseline. One- and six-months later, percentages were 8% and 9%. In SAVR patients, 18% had baseline scores indicating anxiety. One and six-months later, percentages were 11% and 9%. Depression was identified in 15% of TAVI patients. One- and six-months later, percentages were 11% and 17%. At baseline, 11% of SAVR patients had scores indicating depression. One- and six-months after SAVR, percentages were 15% and 12%. Longitudinal analyses showed reductions (P < 0.001) in anxiety from baseline to one-month, and stable scores between one- and six-months for both treatment groups. There was no change over time for depression among treatment groups (P = 0.21).
SAVR or TAVI in patients ≥ 80 years was associated with anxiety reduction between baseline and follow-up. For depression, there was no evidence of change over time in either treatment group.
对于最年长的患者，在接受先进的心脏手术后，关于心理健康的了解甚少。
研究在接受经导管主动脉瓣置换术（TAVI）或外科主动脉瓣置换术（SAVR）的老年患者中，从基线到 1 个月和 6 个月随访时焦虑和抑郁的变化。
前瞻性队列研究，在一家三级大学医院对接受择期 TAVI 或 SAVR 的患者≥80 岁。使用医院焦虑和抑郁量表评估焦虑和抑郁。使用 Welch t 检验或卡方检验分析 TAVI/SAVR 之间的差异。使用广义最小二乘法的纵向模型确定随时间的变化和组间差异。
在 143 名患者（83.5±2.7 岁）中，46%（n=65）接受了 TAVI。在 TAVI 患者中，基线时有 11%存在焦虑。1 个月和 6 个月后，百分比分别为 8%和 9%。在 SAVR 患者中，18%的基线评分表明存在焦虑。1 个月和 6 个月后，百分比分别为 11%和 9%。TAVI 患者中有 15%被诊断为抑郁。1 个月和 6 个月后，百分比分别为 11%和 17%。在基线时，11%的 SAVR 患者的评分表明存在抑郁。SAVR 后 1 个月和 6 个月，百分比分别为 15%和 12%。纵向分析显示，两组患者的焦虑均从基线下降（P<0.001），在 1 个月和 6 个月之间保持稳定。两组患者的抑郁均未随时间发生变化（P=0.21）。
对于≥80 岁的患者，SAVR 或 TAVI 与基线至随访时的焦虑减轻相关。对于抑郁，两组患者均未随时间发生变化。
