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ORIGINAL ARTICLE
Year : 2018  |  Volume : 131  |  Issue : 16  |  Page : 1951-1957

Risk Factors for Preoperative Anxiety and Depression in Patients Scheduled for Abdominal Aortic Aneurysm Repair


Department of Vascular Surgery, West China Hospital, Chengdu, Sichuan 610041, China

Correspondence Address:
Dr. Yu-Kui Ma
Department of Vascular Surgery, West China Hospital, No. 37, Guoxue Alley, Chengdu, Sichuan 610041
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0366-6999.238154

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Background: Perioperative emotional disorders of patients underwent abdominal aortic aneurysm (AAA) repair is an emerging area of study, and preoperative mental distress of those patients remains poorly understood. The aim of this study was to investigate the prevalence and identify the risk factors of preoperative anxiety and depression in patients scheduled for AAA repair. Methods: A total of 189 patients who underwent elective AAA repair between 2015 and 2016 were included in this study. These patients were preoperatively evaluated by Hospital Anxiety and Depression Scale (HADS). Demographics and anxiety and depression scores of the patients were documented. Logistic regression was used to identify the independent risk factors of preoperative anxiety and depression. Results: A total of 150 AAA patients were included in final analysis. Of these 150 patients, 44 patients (29.3%) had borderline anxiety or clinical anxiety, and 42 patients (28.0%) were found to have borderline or clinical depression. Female (odds ratio [OR]: 2.81, 95% confidence interval [CI]: 1.08–7.26), the American Society of Anesthesiologists (ASA) Grade 3/4 (OR: 4.34, 95% CI: 1.13–16.68), higher education (OR: 1.44, 95% CI: 1.02–2.04), and abdominal or back pain (OR: 3.08, 95% CI: 1.20–7.87) were identified as significant independent risk factors of abnormal HADS-anxiety in overall patients; and higher level of education (OR: 1.87, 95% CI: 1.16–3.01) was predictive of anxiety in patients planned for endovascular aortic repair. Besides, higher body mass index (BMI) (OR: 1.18, 95% CI: 1.04–1.33) and abdominal or back pain (OR: 3.93, 95% CI: 1.70–9.11) were predictive of abnormal preoperative HADS-depression in overall patients. Conclusion: As for patients scheduled for AAA repair, female, higher ASA, higher level of education, and symptom may be independent risk factors for preoperative anxiety, and symptom and higher BMI may predict preoperative depression.

 

 Abstract in Chinese

腹主动脉瘤患者术前焦虑抑郁危险因素分析

摘要

背景:腹主动脉瘤患者围手术期心理异常逐渐受到研究者关注,而术前焦虑与抑郁情况仍不清楚。本研究目的为探索腹主动脉瘤术前患者焦虑与抑郁的发生率与其危险因素。

方法:本横断面研究纳入189例术前使用医院焦虑抑郁量表(HADS)评估的腹主动脉瘤患者。收集基本信息及焦虑抑郁评分,使用logistic回归确定独立危险因素。

结果:本研究最终纳入150例腹主动脉瘤患者,其中44例(29.3%)患者有交界性或临床焦虑,43例患者有交界性或临床抑郁。研究发现女性(OR: 2.81,95% CI: 1.08-7.26),ASA分级3或4(OR: 4.34,95% CI: 1.13-16.68),高教育等级(OR: 1.14,95% CI: 1.02-2.04)及腰腹痛(OR 3.08,95% CI: 1.20-7.87)为异常HADS-A评分的危险因素,其中高教育等级(OR: 1.87,95% CI: 1.16-3.01)为腹主动脉瘤腔内修复术前焦虑危险因素。高BMI (OR: 1.18, 95% CI: 1.04-1.33) 及腰腹痛 (OR: 3.93, 95% CI: 1.70-9.11) 为术前异常HADS-D评分的危险因素。

结论:女性、高ASA、高教育水平及腰腹痛为腹主动脉瘤术前焦虑危险因素,而高BMI及腰腹痛为腹主动脉瘤术前抑郁危险因素。



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