Preoperative state of mind among patients undergoing CABG: effect on length of stay and postoperative complications.
This study was undertaken to determine if a pessimistic self-assessment prior to an elective coronary artery bypass graft (CABG) was predictive of postoperative complications and increased length of stay (LOS). Subjects (n = 565), aged 65 and older and undergoing elective CABG, were stratified into 2 groups (optimistic, pessimistic) based on their mental health subscale scores prior to surgery. After adjusting for age, gender, and severity of disease, the average LOS for pessimistic patients was 1.3 days longer than for optimistic patients. Despite adjustment for previous CABG, renal failure, peripheral vascular disease, and gender, pessimism was associated with an increased risk of prolonged ventilation time and permanent stroke. Negative state of mind prior to a major cardiovascular intervention may be predictive of increased LOS, permanent stroke, and prolonged ventilation time.
Halpin
Linda S
LS
Inova Heart and Vascular Institute at Fairfax Hospital, Falls Church, VA 22042, USA. lindahalpin@inova.com
Barnett
Scott D
SD
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001294:Attitude to Health; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000523:psychology*; D003327:Coronary Disease / Q000145:classification / Q000523:psychology / Q000601:surgery; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008603:Mental Health; D009341:Negativism; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D012647:Self-Assessment; D012720:Severity of Illness Index; D020521:Stroke / Q000453:epidemiology / Q000209:etiology; D011795:Surveys and Questionnaires; D017749:Total Quality Management / Q000458:organization & administration; D014768:Virginia / Q000453:epidemiology