Stenman Malin, Jackson Veronica, Särnholm Josefin, Falk Anna, J Nielsen Susanne, Sartipy Ulrik
Department of Molecular Medicine and Surgery, Karolinska Institutet, 17177, Stockholm, Sweden.
Perioperative Medicine and Intensive Care Function, Karolinska University Hospital, 17176, Stockholm, Sweden.
Eur J Cardiothorac Surg. 2025 Aug 2;67(8). doi: 10.1093/ejcts/ezaf277.
Preoperative depression is common among patients with cardiovascular disease and a significant risk factor for worse outcomes after cardiac surgery. This review summarizes the current evidence on depression as a risk factor and possible treatment options in patients undergoing cardiac surgery, and highlights future perspectives for clinical research.
This narrative review was based on a selection of key papers, identified through collegial expert discussions rather than a systematic literature search.
Depression is often underdiagnosed and undertreated in patients undergoing cardiac surgery, significantly affecting recovery and increasing the risk of adverse outcomes. Implementing systematic psychological screening for depression and anxiety preoperatively and during follow-up is crucial for identifying at-risk patients. Psychological interventions, especially cognitive behavioral therapy have been shown to offer substantial benefits. Adopting a multidisciplinary approach integrating cardiovascular and psychological care is essential for improving recovery and long-term outcomes. Incorporating psychological screening and interventions into standard care can enhance postoperative outcomes, reduce complications, and provide comprehensive support for cardiac surgery patients.
Depression is often overlooked in cardiac surgery patients, despite its significant impact on recovery and long-term outcomes. Systematic psychological screening before and after surgery together with a multidisciplinary approach integrating cardiovascular and psychological care can improve patient outcomes. Future research should clarify how depression and cardiovascular disease are linked, assess treatment effectiveness, and identify appropriate intervention strategies.
术前抑郁在心血管疾病患者中很常见,并且是心脏手术后预后较差的一个重要危险因素。本综述总结了目前关于抑郁作为心脏手术患者危险因素及可能治疗选择的证据,并强调了临床研究的未来前景。
本叙述性综述基于通过同行专家讨论而非系统文献检索选定的关键论文。
心脏手术患者中,抑郁常常诊断不足且治疗不充分,这显著影响恢复并增加不良结局风险。术前及随访期间对抑郁和焦虑进行系统的心理筛查对于识别高危患者至关重要。心理干预,尤其是认知行为疗法已显示出有显著益处。采用将心血管护理与心理护理相结合的多学科方法对于改善恢复及长期结局至关重要。将心理筛查和干预纳入标准护理可改善术后结局、减少并发症,并为心脏手术患者提供全面支持。
尽管抑郁对心脏手术患者的恢复和长期结局有重大影响,但在这些患者中常常被忽视。术前和术后进行系统的心理筛查以及采用将心血管护理与心理护理相结合的多学科方法可改善患者结局。未来研究应阐明抑郁与心血管疾病如何关联,评估治疗效果,并确定合适的干预策略。