Thorac Cardiovasc Surg 2012; 60 - V65
DOI: 10.1055/s-0031-1297455

Perioperative and long-term development of anxiety and depression in CABG – patients

B Korbmacher 1, S Ulbrich 1, H Dalyanoglu 1, R Schäfer 2, JD Schipke 1, M Franz 2, A Lichtenberg 1
  • 1Klinik für Kardiovaskuläre Chirurgie der Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany
  • 2Klinisches Institut f. Psychosomatische Medizin-Universität Düsseldorf, Düsseldorf, Germany

Aims: Obviously, there is no doubt that close interactions exist between anxiety and depression on the one and the subjective and objective severity of the course of CABG – patients.

Fatigue, anxiety, and vital exhaustion seem to be mayor factors for worsening the situation of patients from CAD, and there is a high incidence of symptomatic transitory psychotic disorder after CABG, leading to forms of a posttraumatic stress disorder and often prolonged hospitalisation. In the long term in many cases a decreased quality of life is observed after CABG. To provide objective data for possible future pre- and postoperative psych-therapeutical interventions a prospective longterm study on CABG-patients was conducted.

Methods: From 2009 to 2010, 135 consecutive patients (46 to 93 ys; 27% females) were consulted by the same person 1 or 2 days before and 6 or 8 days after surgery. Patients filled in among others a questionnaire on the topic of being satisfied with life („Fragebogen zur Lebenszufriedenheit“ (FLZ)), the German version of “Hospital Anxiety and Depression Scale” (HADS). After 6 months patients were asked to fill in the questonnaires a third time.

Results: Before surgery 20.7% of patients had increased depression scores (DS; ≥8), short time after surgery 23.8% and 6 months after surgery 29.3%.

38.4% of patients had preoperative elevated anxiety scores (AS; ≥8), postoperative 34.1% and after 6 months 29.1%.

4 patients died perioperatively showing no elevated DS and AS.

Postoperatively, 16 patients were unable to complete the forms for several reasons, median DS and AS were 8 and 6 compared to median 4 and 7 in the “healthy” patients.

25% experienced OPCAB with no difference of DS and AS.

Conclusions:

a) DS were doubled before and early after surgery compared with the normal population, and tripled 6 months after CABG,

b) AS were – expectedly – extremely high before CABG, but remained on a high level even 6 months after surgery, indicative for anxiety disdorder,

c) Preoperative elevated DS seemed to correlate with an increased complcation rate,

d) Mortality was not associated with an increased DS and AS, e) Surgical technique had no impact on DS and AS.