Objective: To evaluate the effectiveness of a program of psychological preparation for invasive procedures in patients with heart disease, candidates for cardiac surgery, to reduce emotional morbidity and improve perception of health related quality of life. Methods: A Quasi-experimental design was used. The study included a non-probabilistic randomized sample of 110 patients treated in the Division of Cardiac Surgery Centro Medico Nacional Siglo XXI Instituto Mexicano del Seguro Social IMSS. They were divided in two groups: Experimental group (n = 44) and Control group (n = 66). Instruments: CHIP Coping Questionnaire, HADS Anxiety and Depression Hospital Scale, Health Related Quality of Life Questionnaire and a Visual Analogue Scale (VAS) to measure postoperative pain. Results: The experimental group showed an increase in instrumental coping style compared to pre (M = 24.55) and post evaluation (M = 25.93); statistically significant differences were found in the variables of stress (p = 0.042), anxiety (p = 0.001), depression (p = 0.056) and health related quality of life (p = 0.000); while in the control group, the distraction coping style (pre M = 25.80, post M = 26.73) is the one that increased; there were no statistically significant differences in the variables stress (p = 0.274), anxiety (p = 0.671) and depression (p = 0.850), except for the health related quality of life (p = 0.000). This study is the first in Mexico to manage emotional comorbidity in this type of population.
Objective: To Validate the EuroSCORE II as a method for cardiac surgery risk stratification in Mexican adult population. Methods: We included adult patients undergoing to cardiac surgery, in order to determine the predictive value of EuroSCORE II on morbidity and mortality risk. Continuous variables are presented as mean ± SD or median with its interquartile range as appropriate; categorical variables were described as n, % or rate. To validate the EuroSCORE II scale, the assessment was done with Hosmer- Lemeshow (HL) test. In terms of discrimination, we used the features of the receiver operation characteristic (ROC) curves. Results: They were 704 patients, grouped into five categories: simple (one vessel) Coronary Artery Bypass Grafting (CABG) surgery, n= 299 (43%) cases. CABG revascularization (two or more vessels), n= 208 (30%). Double Procedure (CABG + valve replacement) 174 (25%) cases. Triple procedure (CABG + valve + aorta surgery) 23 (3.3%) patients. The mortality observed within 30 days of the surgery was 88 (12.5%). Meanwhile, the mean of the expected mortality predicted by EuroSCORE II was 3.63 ± 5.91 (95% CI: 3.19-4.06). The EuroSCORE II scale presented a good capacity for discrimination in the studied population reaching an area under the ROC curve of 0.821 (p < 0.000, 95% CI: 0.772-0.871). A calibration for the scale measured through logistic regression with goodness of adjustment of Hosmer-Lemeshow was determined (χ2 = 17.74, p = 0.64). Conclusion: EuroSCORE II showed moderate discrimination ability in general. The scale can be useful to identify some problems in our hospital, however, the mortality rate might be underestimated. Key words: Euroscore II; Adult Cardiac Surgery; Surgical Risk
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