Do depression and anxiety profiles over time predict persistent post‐surgical pain? A study in cardiac surgery patients

Pagé, M. Gabrielle; Watt‐Watson, Judy; Choinière, Manon

doi:10.1002/ejp.998

Cited by 23 publications

(22 citation statements)

References 47 publications

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“…Hay referencias de que estos trastornos de humor pre-operatorios reflejan en mayor incidencia de ansiedad y depresión postoperatoria, y que la misma resulta en mayor mortalidad a largo plazo (11,15,16) . Acerca de la repercusión postoperatoria, otro seguimiento con 1071 pacientes mostró que la ansiedad pre-operatoria, que perdura después de la cirugía, es predictora de dolor torácico postoperatorio por dos años (17) ..…”

Section: Discussionunclassified

Risk factors for anxiety and depression in the preoperative period of cardiac surgery

et al. 2019

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Nº 54 Abril 2019Página 426 ORIGINALES Factores de riesgo para ansiedad y depresión en el periodo preoperatorio de cirugía cardiacaFatores de risco para ansiedade e depressão no período pré-operatório de cirurgia cardíaca Risk factors for anxiety and depression in the preoperative period of cardiac surgery Objetivo: Evaluar los factores de riesgo de ansiedad y depresión en el período preoperatorio de la cirugía cardíaca. Método: Se trata de un estudio seccional, realizado entre enero y junio de 2017, en un hospital universitario de referencia en cardiología en el nordeste de Brasil. Se evaluaron 174 pacientes utilizando un cuestionario propio y la Escala Hospitalaria de Ansiedad y Depresión (HADS) y calculadas las Odds Ratios para evaluar el riesgo. Resultados: En la evaluación de la ansiedad, fueron factores de riesgo significativos: sexo femenino, años de estudio, ausencia de acompañante, experiencia previa de cirugía cardiaca y la cancelación de la cirugía durante el internamiento. En cuanto a la depresión, se revelaron factores de riesgo: sexo femenino y tiempo de internamiento mayor de 15 días. Conclusión: El enfermero tiene instrumentos disponibles para reconocer la ansiedad y la depresión, incluyendo los diagnósticos de enfermería y las escalas validadas, así como tiene un papel preponderante en la actuación en estos casos. Debe ser un desafío institucional dinamizar el servicio para evitar prolongaciones de la internación y cancelaciones de cirugía por cuestiones estructurales. Nº 54 Abril 2019 Página 427 RESUMO: Objetivo: avaliar os fatores de risco de ansiedade e depressão no período pré-operatório de cirurgia cardíaca. Método: Trata-se de um estudo seccional, realizado entre janeiro e junho de 2017, em um hospital universitário de referência em cardiologia no nordeste do Brasil. Foram avaliados 174 pacientes utilizando-se um questionário próprio e a Escala Hospitalar de Ansiedade e Depressão (HADS) e calculadas as Odds Ratios para avaliar o risco. Resultados: Na avaliação da ansiedade, foram fatores de risco significativos: sexo feminino, anos de estudo, ausência de acompanhante, experiência prévia de cirurgia cardíaca e o cancelamento da cirurgia durante o internamento. Quanto à depressão, revelaram-se fatores de risco: sexo feminino e tempo de internamento maior de 15 dias. Conclusão: O enfermeiro tem instrumentos disponíveis para reconhecer a ansiedade e a depressão, incluindo os diagnósticos de enfermagem e as escalas validadas, assim como tem papel preponderante na atuação nestes casos. Deve ser um desafio institucional dinamizar o serviço de forma a evitar prolongamentos do internamento e cancelamentos de cirurgia por questões estruturais. ABSTRACT:Objective: To evaluate the risk factors of anxiety and depression in the preoperative period of cardiac surgery.Method: This is a sectional study, conducted between January and June 2017, in a university hospital of reference in cardiology in northeastern Brazil. A total of 174 patients were evaluated using their own questionnaire and the Hospital Anxie...

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Section: Discussionunclassified

Risk factors for anxiety and depression in the preoperative period of cardiac surgery

et al. 2019

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“…A total of 1,247 patients participated in the CARD-PAIN study 7 and 1,071 completed at least two time points. 35 The CARD-PAIN sample was predominantly male (79%), with a mean age of 61.9 years (SD=10.2), and most participants underwent a coronary artery bypass grafting (CABG) procedure with or without a valve replacement (VR) (77%). A detailed description of these patients is available elsewhere.…”

Section: Resultsmentioning

confidence: 99%

“…A detailed description of these patients is available elsewhere. 35 Only patients who reported suffering from CPSP at the 6-, 12- and/or 24-month follow-ups were included in the present study, and data collected at each time point were analyzed independently to maximize sample size. Briefly, 18%, 13% and 9% of patients reported suffering from CPSP at 6-, 12-, and 24-month follow-ups, respectively ( Figure 1 ).…”

Section: Resultsmentioning

confidence: 99%

Just how much does it cost? A cost study of chronic pain following cardiac surgery

Guertin¹,

Pagé²,

Tarride³

et al. 2018

JPR

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ObjectiveThe study objective was to determine use of pain-related health care resources and associated direct and indirect costs over a two-year period in cardiac surgery patients who developed chronic post-surgical pain (CPSP).MethodsThis multicentric observational prospective study recruited patients prior to cardiac surgery; these patients completed research assistant-administered questionnaires on pain and psychological characteristics at 6, 12 and 24 months post-operatively. Patients reporting CPSP also completed a one-month pain care record (PCR) (self-report diary) at each follow-up. Data were analyzed using descriptive statistics, multivariable logistic regression models, and generalized linear models with log link and gamma family adjusting for sociodemographic and pain intensity.ResultsOut of 1,247 patients, 18%, 13%, and 9% reported experiencing CPSP at 6, 12, and 24 months, respectively. Between 16% and 28% of CPSP patients reported utilizing health care resources for their pain over the follow-up period. Among all CPSP patients, mean monthly pain-related costs were CAN$207 at 6 months and significantly decreased thereafter. More severe pain and greater levels of pain catastrophizing were the most consistent predictors of health care utilization and costs.DiscussionHealth care costs associated with early management of CPSP after cardiac surgery seem attributable to a minority of patients and decrease over time for most of them. Results are novel in that they document for the first time the economic burden of CPSP in this population of patients. Longer follow-up time that would capture severe cases of CPSP as well as examination of costs associated with other surgical populations are warranted.SummaryEconomic burden of chronic post-surgical pain may be substantial but few patients utilize resources. Health utilization and costs are associated with pain and psychological characteristics.

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“…However, a study of cardiac surgery patients showed that anxiety was predictive of persistent postoperative pain for up to two years and that depression did not have the same effect on pain risk. 26 A meta-analysis study that evaluated, among 13 clinical trials, the use of psychotherapy versus conventional therapy to treat postoperative pain is highlighted. Psychotherapy (cognitive behavioral therapy and relaxation therapy) and educational therapy for persistent postoperative pain control were tested.…”

Section: /13mentioning

confidence: 99%

Relationship of Anxiety and Preoperative Depression With Post-Operative Pain

Periañez

Diaz

Bonisson

et al. 2020

Texto contexto - enferm.

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Objectiv:e to analyze the relationship of anxiety and depression in the preoperative period with the presence of pain in the postoperative period. Method: cohort study conducted at a university hospital in the state of Minas Gerais (Brazil), between february and July 2017, with 65 patients. A collection instrument was elaborated for the demographic and clinical characteristics. The Hospital Anxiety and Depression Scale was used to assess anxiety and depression; pain intensity was measured using the Verbal Numerical Scale. Data were submitted to descriptive and inferential statistical analysis. Results: according to demographic and clinical characteristics, most patients were female, with a median age of 44 years and surgical specialty of the digestive tract. In the preoperative period, 31 (47.7%) had anxiety, and nine (13.8%), depression. None of the patients reported pain immediately prior to surgery. The incidence of moderate to severe postoperative pain was 32 (49.2%) patients. There was a statistically significant difference in the distribution of patients with postoperative pain in relation to the presence or absence of preoperative anxiety (p value <0.001). There is no statistically significant difference in the distribution of patients with postoperative pain in relation to the presence or absence of preoperative depression (0.733). In multivariate analysis, preoperative anxiety was a predictive factor for postoperative pain. Depression was not a predictive factor of postoperative pain. Conclusion: It was demonstrated that, regardless of the demographic and clinical characteristics of the studied sample, the presence of anxiety in patients in the preoperative period is a predictive factor of postoperative pain.

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Do depression and anxiety profiles over time predict persistent post‐surgical pain? A study in cardiac surgery patients

Cited by 23 publications

References 47 publications

Risk factors for anxiety and depression in the preoperative period of cardiac surgery

Risk factors for anxiety and depression in the preoperative period of cardiac surgery

Just how much does it cost? A cost study of chronic pain following cardiac surgery

Relationship of Anxiety and Preoperative Depression With Post-Operative Pain

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