Assessment Of Perioperative Anxiety And Depression In Adult Cardiac Surgery Patients: Contributing Factors And Postoperative Morbidity

Objective: To measure perioperative levels of anxiety and depression in patients scheduled undergoing cardiac surgery,identify their clinical influencing factors,and assess their correlation with postoperative complications.Methods: We conducted a prospective observational study of 112 patients scheduled to undergo cardiac surgery(coronary artery transplantation or/and valve replacement or valvoplasty)from January 2019 to December 2019 at the center.After informed consent,patients were evaluated the psychological state 1-2 days preoperatively and 6-8 days postoperatively with the Hospital Anxiety and Depression Scale(HADS),and their demographic data(age,gender,body mass index,etc.)and preoperative clinical characteristics(hypertension,diabetes,hyperlipidemia,etc.)were statistically analyzed according to the preoperative questionnaire completed by patients to identify the possible influencing factors of perioperative anxiety,depression.According to the result of HADS assessment divided the patients into anxiety group and no anxiety,depression and no depression group,analyzing the changes of the perioperative patients with anxiety and/or depression and the correlation with the main outcome measure occurring during the hospitalization about all-cause mortality or major morbidity(stroke,renal failure,prolonged ventilation,wound infection,ICU length of hospital stay,use of postoperative painkillers,postoperative hospital stay or reoperation).Results: About 1/3 of the 112 patients in this study developed perioperative anxiety and depression disorder,and the postoperative anxiety and depression levels were higher than those preoperative(P<0.001).Single factor analysis results showed that there were statistical significance between the patients with and without anxiety/depression in gender,educational level,living alone,smoking,poorer sleep,hypertension,ejection fraction ?50%(P<0.05),and found that the females seemed more likely to have mood disorders than the males(P<0.05).Logistic regression analysis further confirmed that women,poorer sleep and low ejection fraction were independent risk factors for perioperative anxiety and depression.We didn't find any correlation between perioperative anxiety and depression with short-term mortality of cardiac surgery(P>0.05),but the positively correlated with prolonged postoperative invasive ventilation time,length of stay in ICU,postoperative painkillers,postoperative length of stay and total hospitalization cost were found.Conclusion: This study result shows that the assessment of psychological social factors in patients undergoing cardiac surgery,especially anxiety and depression mental disorders,can help to identify clinical risk level about patients with anxiety and depression,and give timely psychological prevention counseling or psychological intervention to improve the patient's mood,so as to reduce their the complications morbidity and medical economic costs.