Original articlesCardiovascularDepression Predicts Mortality Following Cardiac Valve Surgery
Section snippets
Patients
Patients were enrolled in the Department of Veteran's Affairs Cooperative Study in Health Services #5, “Processes, Structures, and Outcomes of Care in Cardiac Surgery” (PSOCS), a multicenter, prospective, observational study investigating the linkages between processes and structures of care and risk-adjusted outcomes. Details of the study have been published previously [11]. Seven hundred thirty-four variables representing patient-related risk factors, processes, structures and outcomes of
Results
Baseline characteristics of the study population are listed in Table 1. Compared to nondepressed patients, depressed patients were younger and more likely had New York Heart Association (NYHA) functional class III or IV symptoms. In addition, depressed patients more likely required urgent or emergent surgery, preoperative intravenous nitroglycerin or peroperative intraaortic balloon pump.
Unadjusted 6-month mortality was 13.2% for depressed patients and 7.6% for nondepressed patients. Univariate
Comment
The objective of this study was to determine the prevalence of preoperative depression and whether depression was predictive of mortality following valve surgery in a multicenter cohort of VA patients. We found that nearly 1 in 3 patients had significant depressive symptoms at baseline. Furthermore, preoperative depression was an independent predictor of 6-month mortality, with a 1.9-fold increased odds of death, even after adjustment for the traditional clinical risk variables. This finding
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