Depressive symptoms and outcome of coronary artery bypass grafting.
BACKGROUND
Depressive symptoms are an independent risk factor for outcome in patients with cardiac disease, but their effect on outcome among patients undergoing coronary artery bypass grafting is not well understood.


OBJECTIVE
To determine whether or not clinical variables including length of stay, readmission rates, and mortality are related to patients' level of depressive symptoms before and after coronary artery bypass grafting.


METHODS
An observational, longitudinal design was used. The Medical Outcomes Study 36-item short-form health survey was used to collect data on depressive symptoms in 416 patients undergoing coronary artery bypass grafting. The distribution of depressive symptoms was correlated with length of stay after the procedure, readmission, and mortality.


RESULTS
The level of depressive symptoms before coronary artery bypass grafting correlated with the level of depressive symptoms at 6 weeks follow-up, both for the individual items "feeling down in the dumps" (r = 0.24, P = .009) and "feeling downhearted" (r = 0.36, P < .001) and for the overall score on the Mental Health scale (r = 0.40, P < .001). Feeling down in the dumps (P = .007) and overall scores on the Mental Health scale (P = .02) were significantly related to readmission within 6 months.


CONCLUSIONS
Higher levels of depressive symptoms before coronary artery bypass grafting are related to higher hospital readmission rates 6 months after the procedure. Nurses can play a pivotal role in determining which patients require evaluation, educating patients, and initiating effective treatment, which may prevent readmission related to depressive symptoms.
Saur
C D
CD
Duke University Medical Center, Durham, NC, USA.
Granger
B B
BB
Muhlbaier
L H
LH
Forman
L M
LM
McKenzie
R J
RJ
Taylor
M C
MC
Smith
P K
PK
D000368:Aged; D015986:Confounding Factors, Epidemiologic; D001026:Coronary Artery Bypass / Q000523:psychology*; D003327:Coronary Disease / Q000401:mortality / Q000523:psychology* / Q000601:surgery*; D003863:Depression / Q000150:complications*; D005260:Female; D006306:Health Surveys; D006801:Humans; D007902:Length of Stay; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D019370:Observation; D010359:Patient Readmission; D012307:Risk Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome