Trastornos del ánimo preoperatorios en cirugía cardiaca: factores de riesgo y morbilidad postoperatoria en la unidad de cuidados intensivos

Abstract

Introduction and objectives To estimate the preoperative levels of anxiety and depression in patients awaiting heart surgery and to identify the risk factors associated with the development of these mood disorders. To evaluate the relationship between preoperative anxiety and depression and postoperative morbidity. Methods Prospective longitudinal study in a sample of 100 patients undergoing heart surgery. We carried out a preoperative structured interview in which the patient completed the Hospital Anxiety and Depression Scale, and sociodemographic (age, sex, marital status, and income) and surgical variables (surgical risk, type of surgery, length of preoperative hospital stay, and surgical history) were also recorded. Pain, analgesic use, and postoperative morbidity were evaluated in the intensive care unit. Results Thirty-two percent of the patients developed preoperative anxiety and 19%, depression. Age <65 years (odds ratio = 3.05; 95% confidence interval, 1.27-7.3) was the only significant risk factor for developing preoperative anxiety. A length of preoperative hospital stay ≥3 days was the main risk factor for preoperative depression (odds ratio = 4.59; 95% confidence interval, 1.6-13.17). Preoperative anxiety significantly increased the postoperative pain and analgesic consumption. Neither anxiety nor depression significantly modified the rest of the postoperative variables associated with morbidity in the intesive care unit. Conclusions Anxiety and depression are mood disorders that are detected in patients awaiting heart surgery, with age <65 years and a prolonged preoperative hospital stay being decisive factors in the development of these conditions. Although preoperative anxiety increased the postoperative pain in these patients, their state of mind did not modify their postoperative course. Full English text available from: www.revespcardiol.org