Increased Depression and Readmission Risk in Patients with New-Onset Angina after the Sichuan Earthquake

Abstract

Earthquake exposure has been associated with adverse consequences for coronary heart disease. However, the natural history and prognostic significance of earthquake-related, new-onset angina have not been characterized. The objective of this study was to evaluate the association between episodes of depressive symptoms and one-year prognosis after the first admission to the hospital among adults with new-onset angina before and after the Sichuan earthquake. One hundred forty-one first hospitalized patients with new-onset angina before and after the Sichuan earthquake underwent psychological assessments during their first admission to the hospital following the earthquake. Patients were followed for 12 months to determine survival status. The independent relationships between baseline variables and readmission risk after the earthquake were examined. Baseline somatic and psychosocial variables were collected with the aid of standard, validated questionnaires. The proportion of patients with moderate/severe depression symptom in the earthquake-related group is higher than among their counterparts (23.7% vs. 8.9%, p = 0.026). Patients with new-onset angina after the Sichuan earthquake had a higher risk of readmission (22.4% vs. 8.9%, p = 0.041) and longer total hospitalization (average of 13.4 ±6.8 vs. 10.7 ±5.5 days, p = 0.015). The risks for readmission was associated with moderate/severe depression (adjusted hazard ratio, 9.18 [95% confidence interval (CI) = 3.09-27.23, p = 0.0000]) and low ejection fraction (adjusted hazard ratio, 6.66 [95%CI = 2.131-20.781, p = 0.001]). Among patients diagnosed with new-onset angina, those with first episode after the Sichuan earthquake generated more moderate/severe depressive symptoms and had a higher risk for readmission and longer hospital stay. Depressive symptoms upon admission and low ejection fractions were significant predictors of 12-month risk for readmission, which indicates that antidepressants should be prescribed.