title: Prevalence and risk analysis for depression after open-heart valve replacement surgery.
abstract: OBJECTIVE
  Cardiac surgery may account for long term complications as depression. Geriatric Depression Scale (GDS) is a reliable 30-item questionnaire for assessing depressive symptoms in several populations. The aim of the present study was to determine the prevalence and predictors of depression after open-heart valve replacement surgery in a portuguese population.
  
  
  METHODS
  Prospective observational study enrolling 52 patients (55.8% men, mean age 67.7 ± 11.3 years) with no history of depression, submitted to elective open-heart valve replacement surgery. Patients completed the GDS questionnaire at 6-month follow-up. Cardiovascular risk factors, medical history, left ventricular function, prescription table, analytical and surgical variables and length of hospital stay were collected to verify its influence on postoperative depression.
  
  
  RESULTS
  Twenty-seven patients (41.4% men, mean age 69.3 ± 10.3 years) had scores consistent with symptoms of depression (GDS score >10), representing 51.9% of the sample. Twenty-one (77.8%) were mildly depressed, 6 (22.2%) were severely depressed and only 4 (19.0%) and 3 (50.0%) were on antidepressants, respectively. Postoperative complications (29.6 vs 8.0%, p=0.045), lower postoperative hemoglobin concentration (8.9 ± 0.8 vs 9.8 ± 1.5 g/dL p=0.015) and longer time of hospitalization (12.2 ± 7.7 vs 8.2 ± 3.4 days, p=0.020) were found to be significant predictors for postoperative depression. No other statistically significant differences were found.
  
  
  CONCLUSIONS
  Depression after open-heart valve replacement surgery is frequent but appears to be generally overlooked. Strategies for systematic screening and early guidance should be implemented to ensure better health and quality-of-life of patients undergoing major cardiac surgery.
authors.affiliation: Departamentos de Anestesiologia do Centro Hospitalar do Tâmega e Sousa, Penafiel, do Centro Hospitalar do Alto Ave, Guimarães e do Centro Hospitalar de Vila Nova de Gaia/Espinho, Portugal.
authors.forename: Joana
authors.initials: J
authors.lastname: Faria
authors.forename: Maria
authors.initials: M
authors.lastname: Gomes
authors.forename: Gabriela
authors.initials: G
authors.lastname: Costa
authors.forename: Ana
authors.initials: A
authors.lastname: Marinho
authors.forename: Diana
authors.initials: D
authors.lastname: Gomes
authors.forename: Fátima
authors.initials: F
authors.lastname: Lima
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003863:Depression / Q000453:epidemiology*; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D015995:Prevalence; D011446:Prospective Studies; D018570:Risk Assessment