title: Consequences of the prolonged waiting time for patient candidates for heart surgery.
abstract: 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.
authors.affiliation: Instituto Dante Pazzanese de Cardiologia, Saúde do Estado de São Paulo.
authors.forename: Nagib
authors.initials: N
authors.lastname: Haddad
authors.forename: Olímpio J N V
authors.initials: OJ
authors.lastname: Bittar
authors.forename: Ana A M
authors.initials: AA
authors.lastname: Pereira
authors.forename: Maria Barbosa
authors.initials: MB
authors.lastname: da Silva
authors.forename: Vivian L
authors.initials: VL
authors.lastname: Amato
authors.forename: Pedro S
authors.initials: PS
authors.lastname: Farsky
authors.forename: Auristela I O
authors.initials: AI
authors.lastname: Ramos
authors.forename: Marcelo
authors.initials: M
authors.lastname: Sampaio
authors.forename: Tarcísio L V
authors.initials: TL
authors.lastname: Almeida
authors.forename: Dikran
authors.initials: D
authors.lastname: Armaganijan
authors.forename: José Eduardo M R
authors.initials: JE
authors.lastname: Sousa
mesh_terms: 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