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Predictors of preoperative depressive risk in patients undergoing coronary artery bypass graft surgery

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Abstract

Aims

Depression is highly prevalent among patients undergoing coronary artery bypass graft (CABG) surgery and represents a significant risk factor for longer hospitalization, increasing health costs and worse outcomes. Nonetheless, preoperative depression is rarely assessed in clinical practice, limiting the possibilities for effective prevention and care. Thus, we sought to develop risk models to determine the depressive risk before CABG based on sociodemographic, clinical and treatment variables.

Methods and Results

One thousand two hundred and thirty-eight CABG-patients completed the 9-item Patient Health Questionnaire (PHQ-9) prior to surgery. Clinical and sociodemographic data were collected by trained study investigators. Overall 21.6% of patients displayed elevated depression scores, which were twice as common in women than in men (34.7 versus 17.9%, P < 0.001). Following bivariate analysis, multiple regression revealed that both dyspnea at rest (OR 1.69, 95% CI 1.11–2.57, P = 0.015) and dyspnea on exertion (OR 2.48, 95% CI 1.61–3.81, P < 0.001), previous myocardial infarction (OR 1.53, 95% CI 1.12–2.08, P = 0.007), comorbidities and medication with tranquillizers; in addition to younger age, female gender, lower school education, and living alone are significantly and independently associated with preoperative depressive symptoms.

Conclusions

Knowledge of these risk factors will allow for better identification of patients at high depressive risk and thereby facilitate optimal treatment in order to improve postoperative outcomes.

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Acknowledgments

We thank Stefanie Röhner for excellent secretarial assistance. This work was supported by Kompetenznetz Herzinsuffizienz (TP13: 01GI205), DFG Graduate Course 754 (GK754), an unrestricted grant from Novartis and the Margarete-Ammon-Stiftung.

Conflict of interest statement

None declared.

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Authors and Affiliations

  1. Berlin Institute of Gender in Medicine (GiM), Charité - Universitätsmedizin Berlin, Luisenstr. 65, 10117, Berlin, Germany

    Anne Dunkel, Elke Lehmkuhl, Sabine Oertelt-Prigione & Vera Regitz-Zagrosek

  2. Institute for Medical Psychology, Charité - Universitätsmedizin Berlin, Luisenstr. 57, 10117, Berlin, Germany

    Friederike Kendel

  3. German Heart Institute Berlin (DHZB), Augustenburger Platz 1, 13353, Berlin, Germany

    Elke Lehmkuhl, Roland Hetzer & Vera Regitz-Zagrosek

  4. Berlin School of Public Health, Charité - Universitätsmedizin Berlin, Oudenarder Str. 16, 13347, Berlin, Germany

    Birgit Babitsch

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  1. Anne Dunkel
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Correspondence to Anne Dunkel.

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Dunkel, A., Kendel, F., Lehmkuhl, E. et al. Predictors of preoperative depressive risk in patients undergoing coronary artery bypass graft surgery. Clin Res Cardiol 98, 643–650 (2009). https://doi.org/10.1007/s00392-009-0050-0

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  • DOI: https://doi.org/10.1007/s00392-009-0050-0

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