Association of preoperative anxiety and depression symptoms with postoperative complications of cardiac surgeries.
Hélen Francine Rodrigues, Rejane Kiyoma Furuya, Rosana Aparecida Spadoti Dantas and 2 others
PMID 30517589WHAT IT FOUND
In 75 patients after first heart bypass surgery, higher preoperative anxiety scores were linked to ICU hemodynamic instability, and higher depression scores were linked to nausea, agitation, intubation over 48 hours and neurological deficit.
These are associations, not proof.
Key findings
01Among 75 patients, those with ICU hemodynamic instability had a higher median preoperative anxiety score (5.0) than those without it (3.0; p=0.012).
02Higher median preoperative depression scores were seen with nausea (4.0 vs 2.0; p=0.002), agitation (7.0 vs 2.0; p<0.001), intubation for more than 48 hours (10 vs 3; p=0.018), and sensorineural deficit (10.5 vs 3.0; p=0.016).
03Female patients had a higher median preoperative anxiety score than male patients (6.0 vs 4.0; p=0.028).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 75 patients from one public university hospital were studied, and all were having a first elective bypass scheduled more than 12 hours ahead and able to answer questionnaires, so results may not apply to other settings or patients excluded for clinical decompensation or cognitive inability. Complications were identified from charts, nursing records, ICU electronic data, and infection-control records, so a complication not documented may have been missed. Patients were followed only during the ICU stay; deaths in the operating room were not included, and one death was observed, so longer-term outcomes are not described. The Hospital Anxiety and Depression Scale measures symptom scores, not diagnosed anxiety or depression, and the paper reported only group comparisons and correlations without describing adjustment for age, comorbidities, surgery factors, or other confounders. Some complication groups were very small, including 5 with intubation for more than 48 hours and 4 with sensorineural deficit, so those associations are unstable.
The easy way to misread this
Do not conclude that treating anxiety or depression will prevent postoperative complications. This was an observational study of 75 patients, with no intervention, no reported adjustment for confounders, and multiple outcome comparisons, so it shows associations only.