A prospective investigation of depression and adverse outcomes in patients undergoing vascular surgical interventions: A retrospective cohort study using a large mental health database in South London
AbstractBackgroundPatients with depression are more susceptible to cardiovascular illness including vascular surgeries. However, health outcomes after vascular surgery among patients with depression is unknown. This study aimed to investigate associations of depression with post-operative health out...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2021-01-01
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| Series: | European Psychiatry |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S092493382100002X/type/journal_article |
| _version_ | 1811156394611572736 |
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| author | Sajini Kuruppu Marvey Ghani Megan Pritchard Matthew Harris Ruwan Weerakkody Robert Stewart Gayan Perera |
| author_facet | Sajini Kuruppu Marvey Ghani Megan Pritchard Matthew Harris Ruwan Weerakkody Robert Stewart Gayan Perera |
| author_sort | Sajini Kuruppu |
| collection | DOAJ |
| description | AbstractBackgroundPatients with depression are more susceptible to cardiovascular illness including vascular surgeries. However, health outcomes after vascular surgery among patients with depression is unknown. This study aimed to investigate associations of depression with post-operative health outcomes for vascular surgical patients.MethodsA retrospective observational study was conducted using data from a large mental healthcare provider and linked national hospitalization data for the same south London geographic catchment. OPCS-4 codes were used to identify vascular procedures. Health outcomes were compared between those with/without depression including length of hospital stay (LOS), inpatient mortality, and 30 day emergency hospital readmissions. Predictors of these health outcomes were also assessed.ResultsVascular surgery was received by 9,267 patients, including 446 diagnosed with depression. Patients with depression had a higher risk of emergency admission for vascular surgery (odds ratio [OR] 1.28; 1.03, 1.59), longer index LOS (IRR 1.38; 1.33–1.42), and a higher risk of 30-day emergency readmission (OR 1.82; 1.35–2.47). Patients with depression had higher inpatient mortality after adjustment for sociodemographic status (1.51; 1.03, 2.23) but not on full adjustment, and had longer emergency readmission LOS (1.13; 1.04, 1.22) after adjustment for sociodemographic factors and cardiovascular disease. Correlates of vascular surgery hospitalization among patients with depression included admission through emergency route for longer LOS, inpatient mortality, and 30-day hospital readmission.ConclusionPatients with depression undergoing vascular surgery have substantially poorer health outcomes. Screening for depression prior to surgery might be indicated to target preventative measures. |
| first_indexed | 2024-04-10T04:49:43Z |
| format | Article |
| id | doaj.art-c06385efa8e0429887d7c9ed2e732627 |
| institution | Directory Open Access Journal |
| issn | 0924-9338 1778-3585 |
| language | English |
| last_indexed | 2024-04-10T04:49:43Z |
| publishDate | 2021-01-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | European Psychiatry |
| spelling | doaj.art-c06385efa8e0429887d7c9ed2e7326272023-03-09T12:33:54ZengCambridge University PressEuropean Psychiatry0924-93381778-35852021-01-016410.1192/j.eurpsy.2021.2A prospective investigation of depression and adverse outcomes in patients undergoing vascular surgical interventions: A retrospective cohort study using a large mental health database in South LondonSajini Kuruppu0Marvey Ghani1Megan Pritchard2https://orcid.org/0000-0001-8872-3614Matthew Harris3https://orcid.org/0000-0003-1800-3915Ruwan Weerakkody4Robert Stewart5https://orcid.org/0000-0002-4435-6397Gayan Perera6https://orcid.org/0000-0002-3414-303XDepartment of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience. King’s College London. United KingdomDepartment of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience. King’s College London. United KingdomSLaM BRC Nucleus, South London and Maudsley NHS Foundation Trust. London. United KingdomDepartment of Vascular Surgery, The Royal Free Hospital, Pond Street, London NW3 2QG, United Kingdom King’s College Hospital NHS Foundation Trust, Denmark Hill, London, United KingdomDepartment of Vascular Surgery, The Royal Free Hospital, Pond Street, London NW3 2QG, United Kingdom King’s College Hospital NHS Foundation Trust, Denmark Hill, London, United KingdomDepartment of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience. King’s College London. United Kingdom SLaM BRC Nucleus, South London and Maudsley NHS Foundation Trust. London. United KingdomDepartment of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience. King’s College London. United Kingdom SLaM BRC Nucleus, South London and Maudsley NHS Foundation Trust. London. United KingdomAbstractBackgroundPatients with depression are more susceptible to cardiovascular illness including vascular surgeries. However, health outcomes after vascular surgery among patients with depression is unknown. This study aimed to investigate associations of depression with post-operative health outcomes for vascular surgical patients.MethodsA retrospective observational study was conducted using data from a large mental healthcare provider and linked national hospitalization data for the same south London geographic catchment. OPCS-4 codes were used to identify vascular procedures. Health outcomes were compared between those with/without depression including length of hospital stay (LOS), inpatient mortality, and 30 day emergency hospital readmissions. Predictors of these health outcomes were also assessed.ResultsVascular surgery was received by 9,267 patients, including 446 diagnosed with depression. Patients with depression had a higher risk of emergency admission for vascular surgery (odds ratio [OR] 1.28; 1.03, 1.59), longer index LOS (IRR 1.38; 1.33–1.42), and a higher risk of 30-day emergency readmission (OR 1.82; 1.35–2.47). Patients with depression had higher inpatient mortality after adjustment for sociodemographic status (1.51; 1.03, 2.23) but not on full adjustment, and had longer emergency readmission LOS (1.13; 1.04, 1.22) after adjustment for sociodemographic factors and cardiovascular disease. Correlates of vascular surgery hospitalization among patients with depression included admission through emergency route for longer LOS, inpatient mortality, and 30-day hospital readmission.ConclusionPatients with depression undergoing vascular surgery have substantially poorer health outcomes. Screening for depression prior to surgery might be indicated to target preventative measures.https://www.cambridge.org/core/product/identifier/S092493382100002X/type/journal_articleAdmissioncardiovasculardepressionmortalitysurgery |
| spellingShingle | Sajini Kuruppu Marvey Ghani Megan Pritchard Matthew Harris Ruwan Weerakkody Robert Stewart Gayan Perera A prospective investigation of depression and adverse outcomes in patients undergoing vascular surgical interventions: A retrospective cohort study using a large mental health database in South London European Psychiatry Admission cardiovascular depression mortality surgery |
| title | A prospective investigation of depression and adverse outcomes in patients undergoing vascular surgical interventions: A retrospective cohort study using a large mental health database in South London |
| title_full | A prospective investigation of depression and adverse outcomes in patients undergoing vascular surgical interventions: A retrospective cohort study using a large mental health database in South London |
| title_fullStr | A prospective investigation of depression and adverse outcomes in patients undergoing vascular surgical interventions: A retrospective cohort study using a large mental health database in South London |
| title_full_unstemmed | A prospective investigation of depression and adverse outcomes in patients undergoing vascular surgical interventions: A retrospective cohort study using a large mental health database in South London |
| title_short | A prospective investigation of depression and adverse outcomes in patients undergoing vascular surgical interventions: A retrospective cohort study using a large mental health database in South London |
| title_sort | prospective investigation of depression and adverse outcomes in patients undergoing vascular surgical interventions a retrospective cohort study using a large mental health database in south london |
| topic | Admission cardiovascular depression mortality surgery |
| url | https://www.cambridge.org/core/product/identifier/S092493382100002X/type/journal_article |
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