38. IN-HOSPITAL DEPRESSION AFTER CABG SURGERY PREDICTING 12-MONTH OUTCOME
Ingrid Connerney, Joseph McLaughlin*
University of Maryland Medical System
Baltimore, Maryland, USA
BACKGROUND
There is considerable evidence that depression is associated with cardiac mortality after MI and in longitudinal studies of initially healthy people. This study was performed to determine if patient depression is a significant factor in CABG surgery outcomes.
MATERIAL AND METHODS
A total of 309 CABG patients underwent structured psychiatric interview assessing in-hospital depression. Patients were contacted by phone 12 months postoperatively, and patientsÂ’ cardiologists verified cardiac mortality and cardiac readmissions.
RESULTS
Sixty-three patients (20.4%) met modified DSM-III-R criteria for major depression. At 12 months, 28.3% (n=17) of 60 major depressed patients had experienced cardiac events, compared to only 10.2% (n=25) of 245 non-depressed patients. Five variables had significant univariate association with cardiac events: gender, living alone, EF, length of stay, and depression. Depression was as significant a predictor as EF < 35 (depression odds ratio 3.7, P=0.001; EF odds ratio .27, P=0.005). Females were three times as likely to have a cardiac event and patients living alone twice as likely. In contrast, depression did not predict deaths/admissions for non-cardiac events.
CONCLUSION
Depression is a significant marker for postcoronary bypass cardiac events, including deaths. Depression influenced these events independent of traditional risk factors. The odds ratio for major depression was almost four-fold and as strong as the one for EF.
