The impact of preoperative anxiety and education level on long-term mortality after cardiac surgeryReport as inadecuate




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Journal of Cardiothoracic Surgery

, 7:86

First Online: 14 September 2012Received: 08 February 2012Accepted: 07 September 2012

Abstract

BackgroundPsychosocial factors have shown independent predictive value in the development of cardiovascular diseases. Although there is strong evidence to support the role of psychosocial factors in cardiovascular mortality, there is a scarcity of knowledge about how these factors are related. Therefore, we investigated the relationship between depression, anxiety, education, social isolation and mortality 7.5 years after cardiac surgery.

MethodsAfter informed consent, 180 patients undergoing cardiac surgery between July 2000 and May 2001 were prospectively enrolled and followed for ten years. During the follow-up period, the patients were contacted annually by mail. Anxiety Spielberger State-Trait Anxiety Inventory, STAI-S-STAI-T, depression Beck Depression Inventory, BDI and the number and reason for rehospitalizations were assessed each year. Those patients who did not respond were contacted by telephone, and national registries were searched for deaths.

ResultsDuring a median follow-up of 7.6 years 25 to 75 percentile, 7.4 to 8.1 years, the mortality rate was 23.6% 95% confidence interval CI 17.3-29.9; 42 deaths. In a Cox regression model, the risk factors associated with an increased risk of mortality were a higher EUROSCORE points; Adjusted Hazard Ratio AHR:1.30, 95%CI:1.07-1.58, a higher preoperative STAI-T score points; AHR:1.06, 95%CI 1.02-1.09, lower education level school years; AHR:0.86, 95%CI:0.74-0.98, and the occurrence of major adverse cardiac and cerebral events during follow up AHR:7.24, 95%CI:2.65-19.7. In the postdischarge model, the same risk factors remained.

ConclusionsOur results suggest that the assessment of psychosocial factors, particularly anxiety and education may help identify patients at an increased risk for long-term mortality after cardiac surgery.

KeywordsMortality Cardiac surgery Anxiety Depression Education AbbreviationsSTAI-SState anxiety subscale in the Spielberger state-trait anxiety inventory

STAI-TTrait anxiety subscale in the Spielberger state-trait anxiety inventory

BDIBeck depression inventory

CIConfidence interval

AHRAdjusted hazard ratio

CABGCoronary artery bypass graft

CBPCardiopulmonary bypass

MACCEMajor adverse cardiac and cerebral event

CHFCongestive heart failure

ICUIntensive care unit.

Electronic supplementary materialThe online version of this article doi:10.1186-1749-8090-7-86 contains supplementary material, which is available to authorized users.

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Author: Zsuzsanna Cserép - Eszter Losoncz - Piroska Balog - Tamás Szili-Török - András Husz - Boglárka Juhász - Miklós D K

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