The combined association of depression and socioeconomic status with length of post-operative hospital stay following coronary artery bypass graft surgery: Data from a prospective cohort study

Poole, Lydia; Leigh, Elizabeth; Kidd, Tara; Ronaldson, Amy; Jahangiri, Marjan; Steptoe, Andrew

doi:10.1016/j.jpsychores.2013.10.019

Cited by 77 publications

(90 citation statements)

References 33 publications

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“…Some sociodemographic characteristics presented by the participants of this study are similar to those of national and international studies of patients with coronary artery disease referred for CABG, such as: the prevalence of males, [11][12][13] presence of a partner, 11,12 low educational level, and age. 11 The results showed that the majority of participants did not practice physical activity, presented a history of angina, myocardial infarction, and arterial hypertension as comorbidities.…”

Section: Discussionsupporting

confidence: 53%

“…14 Hypertension was also the most prevalent comorbidity presented by patients undergoing CABG in other studies. [11][12][13] The average BDI was 13.0, higher than the cutoff point for classifying the absence of depression and, at the same time, in the range established for classifying dysphoria. In another Brazilian study with 78 patients in the pre-CABG period, which had sociodemographic and clinical characteristics similar to those presented by the participants of this study, the mean BDI was less than nine.…”

Section: Discussionmentioning

confidence: 99%

“…7,12 The literature suggests various cutoff points to classify levels of depression applying the BDI, which hinders the comparison of results. The presence of depressive symptoms in the preoperative period is associated with an increased length of hospital stay; 6,12 thus, to assess the presence of these symptoms, preoperatively, can support the planning of nursing care for coronary heart disease patients before and after CABG.…”

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confidence: 99%

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Depressive symptoms in patients with coronary artery disease

et al. 2016

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Objective.To assess the presence of depressive symptoms in patients with coronary artery disease in the preoperative period for coronary artery bypass surgery (CABG) in Aracaju, Sergipe, Brazil. Methods. A cross-sectional study with 63 hospitalized patients prior to CABG. Two instruments were used for data collection; one for the sociodemographic and clinical characteristics, and the other to evaluate the presence of depressive symptoms, Beck Depression Inventory (BDI). Results. The mean age was 58 years; most were male (60.3%); with a partner (81%) low educational level (71.4% attended school through elementary school). Among the patients, 36.5% were classified with dysphoria, and 25.4% had some degree of depression (6.3% mild, 17.5% moderate, and 1.6% severe). The group of patients with lower educational level presented higher depressive symptoms. Conclusion. Six of every ten patients with coronary artery disease showed dysphoria or some degree of depression. The results of this study can support the planning of nursing care for patients before and after CABG, as well as the development of public health policies to ensure complete, quality care for these patients, understanding depression as a variable that can interfere with recovery after cardiac surgery.

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Section: Discussionsupporting

confidence: 53%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Depressive symptoms in patients with coronary artery disease

et al. 2016

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“…Only recently have researchers begun to appreciate the information to be learned by considering both sets of factors simultaneously to better identify persons at elevated risk of poor cardiovascular outcomes and mortality 21, 23, 24, 25, 41. Whereas most prior work in this area has focused on the joint contributions of SES and a single psychosocial risk factor (eg, depression, stress), our research emphasized the importance of considering a confluence of psychosocial risk factors, in addition to SES, to identify those who are most vulnerable to CVD.…”

Section: Discussionmentioning

confidence: 99%

Effects of Concurrent Depressive Symptoms and Perceived Stress on Cardiovascular Risk in Low‐ and High‐Income Participants: Findings From the Reasons for Geographical and Racial Differences in Stroke (REGARDS) Study

Sumner

Khodneva

Muntner

et al. 2016

JAHA

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BackgroundPsychosocial risk for cardiovascular disease (CVD) may be especially deleterious in persons with low socioeconomic status. Most work has focused on psychosocial factors individually, but emerging research suggests that the confluence of psychosocial risk may be particularly harmful. Using data from the Reasons for Geographical and Racial Differences in Stroke (REGARDS) study, we examined associations among depressive symptoms and stress, alone and in combination, and incident CVD and all‐cause mortality as a function of socioeconomic status.Methods and ResultsAt baseline, 22 658 participants without a history of CVD (58.8% female, 41.7% black, mean age 63.9±9.3 years) reported on depressive symptoms, stress, annual household income, and education. Participants were classified into 1 of 3 psychosocial risk groups at baseline: (1) neither depressive symptoms nor stress, (2) either depressive symptoms or stress, or (3) both depressive symptoms and stress. Cox proportional hazards models were used to predict physician‐adjudicated incident total CVD events (nonfatal myocardial infarction, nonfatal stroke, and cardiovascular death) and all‐cause mortality over a median of 7.0 years (interquartile range 5.4–8.3 years) of follow‐up. In fully adjusted models, participants with both depressive symptoms and stress had the greatest elevation in risk of developing total CVD (hazard ratio 1.48, 95% CI 1.21–1.81) and all‐cause mortality (hazard ratio 1.33, 95% CI 1.13–1.56) but only for those with low income (<$35 000) and not high (≥$35 000) income. This pattern of results was not observed in models stratified by education.ConclusionsFindings suggest that screening for a combination of elevated depressive symptoms and stress in low‐income persons may help identify those at increased risk of incident CVD and mortality.

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“…Considerable evidence details the association between depression and poor recovery both in the immediate period following CABG surgery and in the longer term (Burg et al ., ; Saur et al ., ). Markers of short‐term recovery, including longer in‐hospital stay following surgery, pain, graft site and wound infection, have been linked with depression (Doering, Moser, Lemankiewicz, Luper, & Khan, ; Poole, Kidd et al ., ; Poole, Leigh et al ., ). Similarly, indices of long‐term recovery such as re‐hospitalization rates, future cardiac events, reductions in quality of life (QoL), and increased mortality have also been associated with depression (Blumenthal et al ., ; Connerney et al ., ).…”

Section: Introductionmentioning

confidence: 98%

Attachment anxiety predicts depression and anxiety symptoms following coronary artery bypass graft surgery

Kidd

Poole

Ronaldson

et al. 2016

British J Health Psychol

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ObjectiveDepression and anxiety are associated with poor recovery in coronary artery bypass graft (CABG) patients, but little is known about predictors of depression and anxiety symptoms.DesignWe tested the prospective association between attachment orientation, and symptoms of depression and anxiety in CABG patients, 6–8 weeks, and 12 months following surgery.MethodOne hundred and fifty‐five patients who were undergoing planned CABG surgery were recruited. Patients completed questionnaires measuring attachment, depression, and anxiety prior to surgery, then 6–8 weeks, and 12 months after surgery.ResultsAttachment anxiety predicted symptoms of depression and anxiety at both follow‐up time points, whereas attachment avoidance was not associated with depression or anxiety symptoms. The findings remained significant when controlling for baseline mood scores, social support, demographic, and clinical risk factors.ConclusionThese results suggest that attachment anxiety is associated with short‐term and long‐term depression and anxiety symptoms following CABG surgery. These results may offer important insight into understanding the recovery process in CABG surgery. Statement of contribution What is already known on this subject? Depression and anxiety symptoms are twice more likely to occur in coronary artery bypass graft (CABG) populations than in any other medical group.Depression and anxiety are associated with poor recovery following cardiac surgery.Predictors of depression and anxiety in CABG patients have been underexplored. What does this study add? This study highlights the importance of close interpersonal relationships on health.Attachment anxiety was prospectively associated with higher levels of depression and anxiety.These results add to understanding mechanisms linked to recovery following CABG.

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The combined association of depression and socioeconomic status with length of post-operative hospital stay following coronary artery bypass graft surgery: Data from a prospective cohort study

Cited by 77 publications

References 33 publications

Depressive symptoms in patients with coronary artery disease

Depressive symptoms in patients with coronary artery disease

Effects of Concurrent Depressive Symptoms and Perceived Stress on Cardiovascular Risk in Low‐ and High‐Income Participants: Findings From the Reasons for Geographical and Racial Differences in Stroke (REGARDS) Study

Attachment anxiety predicts depression and anxiety symptoms following coronary artery bypass graft surgery

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