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

Abstract

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. 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. 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.