Preoperative Depression and Anxiety Impact on Inpatient Surgery Outcomes
Objectives:. To determine the association of preoperative mood symptoms and postoperative adverse outcomes; to explore sex-specific differences. Background:. Depression and anxiety can increase postoperative mortality. Psychological stress is associated with a chronic inflammatory response unfavorab...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Health
2021-03-01
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| Series: | Annals of Surgery Open |
| Online Access: | http://journals.lww.com/10.1097/AS9.0000000000000049 |
| _version_ | 1797732790967468032 |
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| author | Roxana Geoffrion, MD Nicole A. Koenig, BA Meimuzi Zheng, MSc Nicholas Sinclair, BSc Lori A. Brotto, PhD Terry Lee, PhD Maryse Larouche, MD MPH |
| author_facet | Roxana Geoffrion, MD Nicole A. Koenig, BA Meimuzi Zheng, MSc Nicholas Sinclair, BSc Lori A. Brotto, PhD Terry Lee, PhD Maryse Larouche, MD MPH |
| author_sort | Roxana Geoffrion, MD |
| collection | DOAJ |
| description | Objectives:. To determine the association of preoperative mood symptoms and postoperative adverse outcomes; to explore sex-specific differences.
Background:. Depression and anxiety can increase postoperative mortality. Psychological stress is associated with a chronic inflammatory response unfavorable to postsurgical healing.
Methods:. Prospective cohort study. Patients were recruited from surgical preadmission clinics at a university hospital. Preoperative depression and anxiety were measured via the Beck Depression and Beck Anxiety Inventories (BDI-II and BAI). Our primary outcome was a composite of postoperative complications, extended length of stay (ELOS) and early readmission. Associated variables included demographics, preoperative pain, pain tolerance/catastrophizing, coping mechanisms, postoperative pain, and opioid use. We adjusted for age, comorbidities, and surgical specialty.
Results:. Of 1061 recruited patients (ten surgical specialties, 2015–2020), 455 males and 486 females had preoperative and postoperative data available. Mean age was 62.9 (range 20.2–96.2). At baseline, 9.3% of patients had moderate or severe depression; 7.4% had moderate or severe anxiety. Females were more likely to be moderately or severely depressed (11% vs 7%, P = 0.036) and moderately or severely anxious (9% vs 6%, P = 0.034). Females had significantly fewer reported comorbidities and lower American Society of Anesthesiologists category (P < 0.001). Increasing BDI-II and BAI scores significantly increased likelihood of postoperative complications, ELOS, and/or hospital readmission in females (adjusted odds ratio [aOR] = 2.57 for BDI-II 1-19 vs 0, P = 0.041; aOR = 4.48 for BDI-II > 19 vs 0, P = 0.008; aOR = 1.54 for BAI ≤ 6 vs >6, P = 0.038) but not in males. Mood symptoms did not influence postoperative pain or opioid use.
Conclusion:. Preoperative depression and anxiety negatively impact surgical outcomes in female patients undergoing major surgery. |
| first_indexed | 2024-03-12T12:19:37Z |
| format | Article |
| id | doaj.art-61c410ae69354882ba6f6686aedcf257 |
| institution | Directory Open Access Journal |
| issn | 2691-3593 |
| language | English |
| last_indexed | 2024-03-12T12:19:37Z |
| publishDate | 2021-03-01 |
| publisher | Wolters Kluwer Health |
| record_format | Article |
| series | Annals of Surgery Open |
| spelling | doaj.art-61c410ae69354882ba6f6686aedcf2572023-08-30T06:08:26ZengWolters Kluwer HealthAnnals of Surgery Open2691-35932021-03-0121e04910.1097/AS9.0000000000000049202103000-00024Preoperative Depression and Anxiety Impact on Inpatient Surgery OutcomesRoxana Geoffrion, MD0Nicole A. Koenig, BA1Meimuzi Zheng, MSc2Nicholas Sinclair, BSc3Lori A. Brotto, PhD4Terry Lee, PhD5Maryse Larouche, MD MPH6From the * University of British Columbia, Vancouver, BC, CanadaFrom the * University of British Columbia, Vancouver, BC, CanadaFrom the * University of British Columbia, Vancouver, BC, CanadaFrom the * University of British Columbia, Vancouver, BC, CanadaFrom the * University of British Columbia, Vancouver, BC, Canada† Centre for Health Evaluation and Outcome Sciences, Vancouver, BC, Canada‡ McGill University, Montreal, QC, Canada.Objectives:. To determine the association of preoperative mood symptoms and postoperative adverse outcomes; to explore sex-specific differences. Background:. Depression and anxiety can increase postoperative mortality. Psychological stress is associated with a chronic inflammatory response unfavorable to postsurgical healing. Methods:. Prospective cohort study. Patients were recruited from surgical preadmission clinics at a university hospital. Preoperative depression and anxiety were measured via the Beck Depression and Beck Anxiety Inventories (BDI-II and BAI). Our primary outcome was a composite of postoperative complications, extended length of stay (ELOS) and early readmission. Associated variables included demographics, preoperative pain, pain tolerance/catastrophizing, coping mechanisms, postoperative pain, and opioid use. We adjusted for age, comorbidities, and surgical specialty. Results:. Of 1061 recruited patients (ten surgical specialties, 2015–2020), 455 males and 486 females had preoperative and postoperative data available. Mean age was 62.9 (range 20.2–96.2). At baseline, 9.3% of patients had moderate or severe depression; 7.4% had moderate or severe anxiety. Females were more likely to be moderately or severely depressed (11% vs 7%, P = 0.036) and moderately or severely anxious (9% vs 6%, P = 0.034). Females had significantly fewer reported comorbidities and lower American Society of Anesthesiologists category (P < 0.001). Increasing BDI-II and BAI scores significantly increased likelihood of postoperative complications, ELOS, and/or hospital readmission in females (adjusted odds ratio [aOR] = 2.57 for BDI-II 1-19 vs 0, P = 0.041; aOR = 4.48 for BDI-II > 19 vs 0, P = 0.008; aOR = 1.54 for BAI ≤ 6 vs >6, P = 0.038) but not in males. Mood symptoms did not influence postoperative pain or opioid use. Conclusion:. Preoperative depression and anxiety negatively impact surgical outcomes in female patients undergoing major surgery.http://journals.lww.com/10.1097/AS9.0000000000000049 |
| spellingShingle | Roxana Geoffrion, MD Nicole A. Koenig, BA Meimuzi Zheng, MSc Nicholas Sinclair, BSc Lori A. Brotto, PhD Terry Lee, PhD Maryse Larouche, MD MPH Preoperative Depression and Anxiety Impact on Inpatient Surgery Outcomes Annals of Surgery Open |
| title | Preoperative Depression and Anxiety Impact on Inpatient Surgery Outcomes |
| title_full | Preoperative Depression and Anxiety Impact on Inpatient Surgery Outcomes |
| title_fullStr | Preoperative Depression and Anxiety Impact on Inpatient Surgery Outcomes |
| title_full_unstemmed | Preoperative Depression and Anxiety Impact on Inpatient Surgery Outcomes |
| title_short | Preoperative Depression and Anxiety Impact on Inpatient Surgery Outcomes |
| title_sort | preoperative depression and anxiety impact on inpatient surgery outcomes |
| url | http://journals.lww.com/10.1097/AS9.0000000000000049 |
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