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August 23, 2016Journal of Behavioral MedicineOpen Access

Pre-surgical depression symptoms were associated with a 13.7% increased hazard of death or major adverse cardiac events per 1-point increment on the Beck Depression Inventory (HR 1.137).

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Why the study?

Do pre-surgical depression and anxiety symptoms predict recovery outcomes (pain, physical symptoms, emergency admissions, death/MACE) in patients undergoing elective CABG surgery?

Population

251 participants undergoing elective coronary artery bypass graft surgery or CABG plus valve replacement…

Design

Cohort

Follow-up

12 months for self-reported outcomes, average 2.68 years…

Key result

Pre-surgical depression symptoms were associated with a 13.7% increased hazard of death or major adverse cardiac events per 1-point increment on the Beck Depression Inventory (HR 1.137).

Authors

LPLydia PoolePreventive CardiologyARAmy RonaldsonKing's College - North CarolinaTKTara KiddLiverpool John Moores University

Discussion

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Member takes

Overview

May support pre-surgical depression screening; leaves open whether intervention reduces cardiac events.

Study Design

Type

Cohort (n=251)

Multicenter

No

Structured PICO

Do pre-surgical depression and anxiety symptoms predict recovery outcomes (pain, physical symptoms, emergency admissions, death/MACE) in patients undergoing elective CABG surgery?

P
Population
251 adult patients undergoing elective CABG surgery, assessed for pre-surgical depression and anxiety, and followed for an average of 2.68 years for clinical outcomes.
E
Exposure
Pre-surgical depression and anxiety symptoms (observational exposure)
O
Outcome
Pain and physical symptoms at 12 months, hospital emergency admissions and death/major adverse cardiac events (MACE) at average 2.68 yearscomposite

Main Result

Hazard Ratio: 1.137 (95% CI 1.042–1.24)

p-value: p=0.004

Pre-operative anxiety predicts self-reported pain and physical symptoms at 12 months, whereas pre-operative depression predicts objective clinical outcomes like emergency admissions and death/MACE up to 2.68 years after CABG surgery.

Limitations

  • Relied on questionnaire measures of mood, restricting generalizability to clinically depressed and anxious samples
  • Small number of death/MACE clinical events prevented controlling for a wide range of clinical and demographic confounders
  • Single-center study design
  • Small event rate in emergency department admission and death/MACE analyses
  • Missing data on self-reported outcomes (n=75)
  • Small sample size

Cite This Study

Poole et al. (2016) conducted a cohort in Coronary artery bypass graft (CABG) surgery (n=251). Pre-surgical depression symptoms vs. Lower depression symptoms was evaluated on Death or major adverse cardiac events (MACE) (HR 1.137, 95% CI 1.042-1.240, p=0.004). Pre-surgical depression symptoms were associated with a 13.7% increased hazard of death or major adverse cardiac events per 1-point increment on the Beck Depression Inventory (HR 1.137).

synapsesocial.com/papers/6a9a8d8a050af52f155ae097https://doi.org/10.1007/s10865-016-9775-1
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Depression and anxiety in coronary artery bypass grafting patients2003 · 163 citations
  2. 2Anxiety and depression in coronary artery bypass surgery patients: A prospective clinical study2022 · 1 citations
  3. 3Risk factors of depressive and anxiety symptoms 8 years after coronary artery bypass grafting2011 · 24 citations
  4. 4A systematic review of pre-operative predictors of post-operative depression and anxiety in individuals who have undergone coronary artery bypass graft surgery2010 · 91 citations
  5. 5The impact of coronary artery bypass graft surgery on depression and anxiety2010 · 27 citations