title: Self-rated health is associated with the length of stay at the intensive care unit and hospital following cardiac surgery.
abstract: BACKGROUND
  Recently, a considerable amount of evidence suggested that anxiety, depression and other psychosocial variables might influence the outcomes of cardiac surgery. This study investigated the relationship between length of stay at the intensive care unit (ICU) and hospital after surgery and different psychosocial variables (e.g. depression, anxiety, self rated health, happiness, satisfaction).
  
  
  METHODS
  We enrolled prospective patients who were waiting for elective cardiac surgery (N = 267) and consented to take part in the study. We collected data of sociodemographic, medical and perioperative factors as well as psychosocial questionnaires completed 1.56 days (standard deviation [SD] = 0.7) before surgery. The primary clinical endpoint was an ICU stay of at least 3 days and the secondary was hospital stay of at least 10 days.
  
  
  RESULTS
  Two hundred sixty-seven patients participated in this study. Four patients (1.5%) died in the hospital and 38 patients (14.5%) spent more than 3 days in the ICU and 62 patients (23.2%) spent more than 10 days in the hospital. After controlling for medical and sociodemographic factors, lower self rated health (Adjusted Odds Ratio [AOR]: 0.51, 95% confidence interval [CI]: 0.28-0.95; p = 0.03), lower rate of happiness (AOR: 0.76, 95% CI: 0.59-0.97, p = 0.03), postoperative cardiac failure (AOR: 7.09, 95% CI:1.21-41.54; p = 0.03) and postoperative complications (AOR: 9.52, 95% CI: 3.76-24.11; p < 0.001) were associated with longer ICU stay. More than 10 days of hospital stay was associated with higher occurrence of COPD (AOR 4.56, CI: 1.95-10.67, p < 0.001), NYHA stage (AOR 6.76, CI: 2.57-17.79, p < 0.001), operation time (AOR 1.45, CI: 1.19-1.76, p < 0.001), female gender (AOR 2.16, CI: 1.06-4.40, p = 0.034) and lower self-rated health (AOR 0.63, CI: 0.41-0.99, p = 0.044).
  
  
  CONCLUSIONS
  Lower happiness and self-rated health may influence the outcome of cardiac surgery. Therefore, these variables should be assessed in patients.
authors.forename: Zsuzsanna
authors.initials: Z
authors.lastname: Cserép
authors.forename: Eszter
authors.initials: E
authors.lastname: Losoncz
authors.forename: Roland
authors.initials: R
authors.lastname: Tóth
authors.forename: Attila
authors.initials: A
authors.lastname: Tóth
authors.forename: Boglárka
authors.initials: B
authors.lastname: Juhász
authors.forename: Piroska
authors.initials: P
authors.lastname: Balog
authors.forename: Péter
authors.initials: P
authors.lastname: Vargha
authors.forename: János
authors.initials: J
authors.lastname: Gál
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Contrada
authors.forename: Paul R J
authors.initials: PR
authors.lastname: Falger
authors.affiliation: The Department of Anesthesia and Intensive Care, Semmelweis University, Budapest, Hungary. szekelya@kardio.hu.
authors.forename: Andrea
authors.initials: A
authors.lastname: Székely
mesh_terms: D001007:Anxiety; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000523:psychology*; D003863:Depression; D004644:Emotions; D005260:Female; D006240:Happiness; D006351:Heart Valves / Q000601:surgery; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010549:Personal Satisfaction; D011446:Prospective Studies