Self-rated health is associated with the length of stay at the intensive care unit and hospital following cardiac surgery

Abstract

BackgroundRecently, a considerable amount of evidence suggested that anxiety, depression and other psychosocial variables might influence the outcomes of cardiac surgery. This study investigated the relationship between length of stay at the intensive care unit (ICU) and hospital after surgery and different psychosocial variables (e.g. depression, anxiety, self rated health, happiness, satisfaction).MethodsWe enrolled prospective patients who were waiting for elective cardiac surgery (N = 267) and consented to take part in the study. We collected data of sociodemographic, medical and perioperative factors as well as psychosocial questionnaires completed 1.56 days (standard deviation [SD] = 0.7) before surgery. The primary clinical endpoint was an ICU stay of at least 3 days and the secondary was hospital stay of at least 10 days.ResultsTwo hundred sixty-seven patients participated in this study. Four patients (1.5%) died in the hospital and 38 patients (14.5%) spent more than 3 days in the ICU and 62 patients (23.2%) spent more than 10 days in the hospital. After controlling for medical and sociodemographic factors, lower self rated health (Adjusted Odds Ratio [AOR]: 0.51, 95% confidence interval [CI]: 0.28-0.95; p = 0.03), lower rate of happiness (AOR: 0.76, 95% CI: 0.59-0.97, p = 0.03), postoperative cardiac failure (AOR: 7.09, 95% CI:1.21-41.54; p = 0.03) and postoperative complications (AOR: 9.52, 95% CI: 3.76-24.11; p < 0.001) were associated with longer ICU stay. More than 10 days of hospital stay was associated with higher occurrence of COPD (AOR 4.56, CI: 1.95-10.67, p < 0.001), NYHA stage (AOR 6.76, CI: 2.57-17.79, p < 0.001), operation time (AOR 1.45, CI: 1.19-1.76, p < 0.001), female gender (AOR 2.16, CI: 1.06-4.40, p = 0.034) and lower self-rated health (AOR 0.63, CI: 0.41-0.99, p = 0.044).ConclusionsLower happiness and self-rated health may influence the outcome of cardiac surgery. Therefore, these variables should be assessed in patients.

Anxiety following cardiac surgery – an important aspect of health status assessment

“…However, as studies show, the patients who have undergone cardiac surgery often experience distress, which may have an adverse influence not only on their social functioning and job performance, but also on their health status, as measured by objective indicators [6]. the association of depression and anxiety with treatment results is most evident in cases of cardiovascular disease [2,7]. moreover, as combined medical and economic research has shown, the depression and anxiety that accompany a chronic disease can lead to an increased number of diagnostic tests and consultations, which may lead to as much as a doubling of treatment costs [8].…”

“…one vital factor in the subjective assessment of health status is the patient's self-assessment of the symptoms they experience, their ability to function, their emotions, and their quality of life [1]. other authors have also pointed out that health status self-assessment should be standard in the evaluation of treatment results of patients who have undergone cardiac surgery [2].…”

“…anxiety after cardiac surgery is associated with an increased number of hospitalizations, adverse treatment outcomes, and even death from cardiovascular factors [11]. anxiety is also considered not only to be a risk factor for cardiovascular disease [13], but also a risk factor for cardiac mortality [2,7].…”

Relação dos sintomas de ansiedade e depressão pré-operatórios e a presença de complicações no pós-operatório de cirurgias cardíacas

“…Apesar do progresso da ciência e tecnologia na área da saúde, com importantes avanços no tratamento das Doenças Cardiovasculares (DCV), como melhores técnicas cirúrgicas e cuidados pós-operatórios, as cirurgias cardíacas podem causar complicações que aumentam tanto a morbidade como a mortalidade pós-operatória (PINTON et al, 2006;SARTIPY, 2013;CSERÉP et al, 2014;KALOGIANNI et al, 2016).…”

“…Quanto ao sexo dos pacientes valvopatas, encontramos uma frequência maior de homens (61,4%), o que também foi constatado em outras pesquisas com pacientes submetidos à correção de valvopatias (HO et al, 2005;CSERÉP et al, 2014;LEON et al, 2016).…”