Epidemiological Investigation Of Mental Disorders In Patients During The Perioperative Of Heart Transplantation,a Cross-sectional Study

Background: Among patients undergoing heart transplantation during the perioperative period,nutritional and mental disorders are common.We found that this type of patients generally has a poor clinical prognosis.However,no studies have reported the relationship between psychological disorders and nutrition,and the outcome of the patients after surgey.Objective: The aim of this study was to explore the relationship between the psychiatric and nutritional disorders of patients during the perioperative period of heart transplantation,as well as the relationship with the short-term clinical prognosis.Methods: The Patient Health Questionnaire-9(PHQ-9)and Generalized Anxiety Disorder-7(GAD-7)and Standard of Controlling Nutritional Status score(CONUT)was used to conducted a cross-sectional survey of preoperative mental,psychological and nutritional status of heart transplant patients(N=49)in the Department of Cardiovascular Surgery of Guangdong Provincial People’s Hospital.We tracked the clinical prognosis of the patient’s after surgery,and analyzed the relationship between psychological and nutritional disorders of the patients about clinical prognosis.Results: Most patients undergoing heart transplantation had symptoms of clinical depression(28.6%)and mild anxiety(32.6%),and 16.3% had severe mental disorders after surgery.Compared with patients with dilated cardiomyopathy,patients with coronary heart disease first diagnosed were older(54 years old VS 35 years old,P<0.001),and had a higher depression score(9 points VS 6 points,P=0.015).32.7% had clinical nutritional disorders.In patients with clinical nutritional disorders,the risk of in-hospital adverse events is increased by6.5 to 8 times,and the risk of concurrent clinical depressive symptoms is increased by 3 to 5times.Cholinesterase levels are lower in patients with clinical depressive symptoms,and the prognosis in the hospital is worse.The risk of adverse events after surgery for patients with preoperative depressive disorder is increased by 8 to 11 times.The degree of depression plays a completely mediating effect between nutritional status and poor prognosis.Conclusion: Depressive disorders and malnutrition are usual in patients who were about undergo the survey about heart transplantation.The degree of depression in these patients is related to the nutritional level,and the worse the nutritional level,the worse the clinical prognosis of the patients had.