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Preoperative and perioperative predictors of reactive and persistent depression after cardiac surgery: A three-month follow-up study

机译：心脏手术后反应性和持续性抑郁的术前和围术期预测因素：三个月的随访研究

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Background: Depression is commonly reported in patients after cardiac surgery and increases the risk of postoperative cardiac morbidity or mortality or both. Although preoperative depression has been implicated as the strongest predictor of depression after surgery, the characteristics thought to influence reactive or persistent depression have been poorly investigated in cardiac surgery patients. Objective: Therefore, the main aim of this study was to examine whether pre-existing depression rather than perioperative variables may predict postoperative reactive or persistent depression. Methods: Overall, 96 patients completed a psychologic evaluation, including the Center for Epidemiologic Studies of Depression scale and the State and Trait Anxiety Inventory for depression and anxiety, respectively, before surgery and at 3-month follow-up. Results: A total of 27 (28%) and 24 (25%) patients had depression preoperatively and at 3-month follow-up, respectively. Postoperative depression was predicted by preoperative scores in Center for Epidemiologic Studies of Depression scale (. β = 0.29, p < 0.05) and European System for Cardiac Operative Risk Evaluation (. β = 0.22, p < 0.04), but not by procedure-related variables (. p > 0.75). Specifically, patients with reactive depression showed greater European System for Cardiac Operative Risk Evaluation than those without depression (. p < 0.05), whereas patients with persistent depression had greater preoperative Center for Epidemiologic Studies of Depression scores than those whose depression improved after surgery (. p < 0.01). Conclusions: The severity of pre-existing depression and biomedical risk factors can be markers of depression-related risk 3 months after cardiac surgery in patients with persistent and reactive depression, respectively. An integrated psychologic and biomedical evaluation is essential to anticipate which patients are likely to show depression after cardiac surgery.
机译：背景：心脏手术后患者通常会感到抑郁，并增加了术后心脏发病率或死亡率或两者兼有的风险。尽管术前抑郁被认为是手术后抑郁的最强预测指标，但在心脏外科手术患者中，对影响反应性或持续性抑郁的特征的研究很少。目的：因此，本研究的主要目的是检查既往存在的抑郁而非围手术期变量是否可以预测术后反应性或持续性抑郁。方法：总体而言，有96名患者在手术前和随访3个月时完成了一项心理评估，包括抑郁症流行病学研究中心量表以及抑郁和焦虑状态和特质焦虑量表。结果：分别有27例（28％）和24例（25％）的患者在术前和3个月的随访中患有抑郁症。根据抑郁症流行病学研究中心的术前评分（。β= 0.29，p <0.05）和欧洲心脏手术风险评估系统（。β= 0.22，p <0.04）来预测术后抑郁。变量（。p> 0.75）。具体而言，反应性抑郁症患者的欧洲心脏手术风险评估系统要强于无抑郁症的患者（.p <0.05），而持续性抑郁症患者的术前抑郁症流行病学研究中心评分要高于那些在手术后抑郁症得到改善的患者。 p <0.01）。结论：对于患有持续性和反应性抑郁症的患者，心脏手术后3个月内先前存在的抑郁症的严重程度和生物医学危险因素可以作为与抑郁症相关的危险的标志。综合的心理和生物医学评估对于预测哪些患者在心脏手术后可能出现抑郁很重要。

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