title: Psychosocial factors and major adverse cardiac and cerebrovascular events after cardiac surgery.
abstract: Our aim was to prospectively examine the association of psychosocial factors with adverse outcome after cardiac surgery. One hundred and eighty cardiac surgery patients were enrolled and contacted annually by mail. Depression [Beck depression inventory (BDI)], anxiety [state anxiety subscale in Spielberger State-Trait Anxiety Inventory (STAI-S) and trait anxiety subscale in Spielberger State-Trait Anxiety Inventory (STAI-T)] were investigated annually, social support, negative affectivity, social inhibition (SI), illness intrusiveness, self-rated health and sleeping disorders were investigated by standardized tests at the second and fifth year. The end-point was the major adverse cardiac and cerebrovascular event (MACCE) including death. Twenty-eight (15.5%) patients died by the end of the fifth year. At the end of the second and fifth years, 146 (81.1%) and 118 (65.5%) patients fulfilled the tests, respectively. At the end of the second year after adjustment for medical and perioperative factors worse self-rated health [adjusted hazard ratio (AHR): 0.67, P=0.006], sleeping disorders (AHR: 1.14, P=0.001), higher illness intrusiveness (AHR: 1.03, P=0.018), higher BDI (AHR: 1.12, P=0.001), STAI-S (AHR: 1.09, P=0.001) and higher STAI-T scores (AHR: 1.08, P=0.002) showed higher risk for MACCE. Significant individual elevation in scores of sleeping disorders, illness intrusiveness and SI were observed over the three-year period in the MACCE group. Assessment of psychosocial factors could help in identifying patients at high-risk for MACCE after cardiac surgery.
authors.affiliation: Department of Anaesthesiology and Intensive Care, Semmelweis University, Budapest, Hungary.
authors.forename: Zsuzsanna
authors.initials: Z
authors.lastname: Cserép
authors.forename: Piroska
authors.initials: P
authors.lastname: Balog
authors.forename: Judit
authors.initials: J
authors.lastname: Székely
authors.forename: András
authors.initials: A
authors.lastname: Treszl
authors.forename: Mária S
authors.initials: MS
authors.lastname: Kopp
authors.forename: Julian F
authors.initials: JF
authors.lastname: Thayer
authors.forename: Andrea
authors.initials: A
authors.lastname: Székely
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000150:complications / Q000175:diagnosis; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000401:mortality; D002561:Cerebrovascular Disorders / Q000209:etiology* / Q000401:mortality / Q000523:psychology; D016009:Chi-Square Distribution; D017281:Cost of Illness; D003863:Depression / Q000150:complications / Q000175:diagnosis; D018572:Disease-Free Survival; D005260:Female; D006331:Heart Diseases / Q000209:etiology* / Q000401:mortality / Q000523:psychology; D006801:Humans; D006814:Hungary; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011788:Quality of Life; D018570:Risk Assessment; D012307:Risk Factors; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications / Q000175:diagnosis; D012944:Social Support; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome