Preoperative Anxiety and Depression Increases the Incidence of Delirium After Coronary Artery Bypass Graft Surgery

Abstract

PurposeTo address the effect of anxiety and depression before coronary artery bypass graft surgery on the postoperative delirium and the length of hospitalization. DesignProspective cohort study. MethodsThe anxiety and depression before surgery was measured using the 14-item Hospital Anxiety and Depression Scale. The main outcome of interest was delirium, which was assessed at baseline and then on the second, third, fourth, and fifth days after surgery, using the nine-item Neecham Confusion Scale. The incidence of delirium was compared in the positive group (153 patients with anxiety and depression at baseline) versus the negative group (153 patients without anxiety and depression at baseline). FindingsThere was a significant difference between the mean score of delirium in the two groups on the second, third, fourth, and fifth days after surgery (P = .001). The incidence of mild and moderate/severe delirium was significantly higher in the positive group than in the negative group for the entire length of follow-up (P = .001). The average length of hospitalization was nearly the same in the two groups (P = .156). ConclusionsThis study indicated that anxiety and depression before coronary artery bypass graft surgery can significantly increase the incidence of postoperative delirium, but it has no significant effect on the length of hospitalization.