Postponement of elective cardiac surgery: A prospective observational analysis of anxiety, depression, social support and clinical complications

Abstract

AimsTo investigate patients' psychological reactions to postponement of elective cardiac surgery, and whether postponement was associated with increased complications post‐operative and while waiting.DesignA single‐centre observational prospective cohort study.MethodsAll adult patients referred for elective cardiac surgery during the study period were considered for inclusion. Psychological data were collected using a survey distributed to patients prior to surgery and at 6 months post‐operative. Clinical data were obtained from patient records.ResultsA total of 83 postponed and 132 non‐postponed patients were included. Postponed patients displayed more avoidance behaviour, but only immediately before surgery. Postponed patients maintained their satisfaction with perceived social support, whereas non‐postponed patients became more dissatisfied over time. Waiting 0–14 days was associated with increased symptoms of depression before surgery compared to non‐postponed patients or those waiting more than 14 days. Surgical complications were the same in both groups. No patients experienced aggravation of their disease leading to urgent or emergent surgery while waiting for surgery. Hospital‐related reasons were the most common cause for postponement of surgery.ConclusionPostponement of selected patients is not associated with increased risk of psychological distress or complications related to the patient's disease.Reporting MethodStrengthening the Reporting of Observational Studies in Epidemiology (STROBE).Implications for Patient CarePre‐ and post‐psychological interventions may be relevant to consider in relation to elective cardiac surgery as it has been shown to positively affect outcome. Organisational/hospital‐related reasons are still very common causes for postponement of elective surgeries, and hospital administrations should focus upon eliminating/decreasing this.Public ContributionQuestionnaires filled by patients were used to understand an association between postponement of cardiac surgery and psychological distress.

Predictors of Psychological Distress among Post-Operative Cardiac Patients: A Narrative Review

“…Carers of cardiac patients often provide considerable physical and emotional support once the patient leaves hospital [78]. Having carer support is associated with a moderate reduction in post-operative distress, and this trend has been found across reviews [79], and quantitative studies [80][81][82][83][84]. However, this association with decreased distress may be confounded with the tendency for distress to decrease over time after cardiac operations [30,64,65].…”