Consequences of the prolonged waiting time for patient candidates for heart surgery.
OBJECTIVE
To assess mortality and the psychological repercussions of the prolonged waiting time for candidates for heart surgery.


METHODS
From July 1999 to May 2000, using a standardized questionnaire, we carried out standardized interviews and semi-structured psychological interviews with 484 patients with coronary heart disease, 121 patients with valvular heart diseases, and 100 patients with congenital heart diseases.


RESULTS
The coefficients of mortality (deaths per 100 patients/year) were as follows: patients with coronary heart disease, 5.6; patients with valvular heart diseases, 12.8; and patients with congenital heart diseases, 3.1 (p<0.0001). The survival curve was lower in patients with valvular heart diseases than in patients with coronary heart disease and congenital heart diseases (p<0.001). The accumulated probability of not undergoing surgery was higher in patients with valvular heart diseases than in the other patients (p<0.001), and, among the patients with valvular heart diseases, this probability was higher in females than in males (p<0.01). Several patients experienced intense anxiety and attributed their adaptive problems in the scope of love, professional, and social lives, to not undergoing surgery.


CONCLUSIONS
Mortality was high, and even higher among the patients with valvular heart diseases, with negative psychological and social repercussions.
Haddad
Nagib
N
Instituto Dante Pazzanese de Cardiologia, Saúde do Estado de São Paulo.
Bittar
Olímpio J N V
OJ
Pereira
Ana A M
AA
da Silva
Maria Barbosa
MB
Amato
Vivian L
VL
Farsky
Pedro S
PS
Ramos
Auristela I O
AI
Sampaio
Marcelo
M
Almeida
Tarcísio L V
TL
Armaganijan
Dikran
D
Sousa
José Eduardo M R
JE
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D006348:Cardiac Surgical Procedures; D003327:Coronary Disease / Q000401:mortality / Q000523:psychology / Q000601:surgery; D005260:Female; D006330:Heart Defects, Congenital / Q000401:mortality / Q000523:psychology; D006331:Heart Diseases / Q000401:mortality* / Q000523:psychology; D006349:Heart Valve Diseases / Q000401:mortality / Q000523:psychology; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D016019:Survival Analysis; D013997:Time Factors; D014850:Waiting Lists