Depression after CABG: a prospective study

Abstract

Introduction Depression during or shortly after hospitalization elevated two to three times the risk of mortality or nonfatal cardiac events, significantly increasing the morbidity and mortality of these patients. Objective To assess the impact of revascularization on symptoms of depression in patients with coronary artery disease. Methods A prospective cohort study of 57 patients of both sexes undergoing coronary artery bypass grafting between June 2010 and June 2011. We used the SF-36 to assess quality of life, and the Beck Depression Inventory to detect depressive symptoms, applied preoperatively and six months. ResultsThe prevalence of patients aged 60-69 years was 22 patients (38.60%), 39 men (68.42%), 26 described themselves as mixed race (45.61%), 16 literate (28.07 %) and 30 married (52.63%). The beck depression inventory score demonstrated increased after revascularization: 15 patients mild (26.32%) at time zero to 17 (29.82%) after. And with moderate, seven patients (12.28%) before and 10 (17.54%) after. In the categories of individuals with decreased minimum degree of 32 (56.14%) to 28 (49.12%), and severe of three (5.26%) for two (3.51%) patients. Association was observed between beck depression inventory, gender, age, lifestyle, comorbidities and quality of life. ConclusionThere was a high prevalence of elevated beck depression inventory scores, lowest scores of depressive symptoms among men and association between the improvement of quality of life scores and beck depression inventory.

Factors associated with impacts on quality of life after myocardial revascularization

“…revascularization"; and that exceeded the one-year period of follow-up of patients submitted to myocardial revascularization. Table 1 presents an overview of the main features of the studies included in the integrative review (17)(18)(19)(20)(21)(22)(23)(24) . The studies were published between the years 2003 and 2013, originating in several countries, as an evidence of the worldwide interest in the theme "quality of life".…”

“…The studies were published between the years 2003 and 2013, originating in several countries, as an evidence of the worldwide interest in the theme "quality of life". Two studies were conducted in the United States of America (18,23) , two in Finland (21)(22) , one in Brazil (17) , one in Norway (19) , one in Poland (20) , and one in Iran (24) . Figure 2 -Flowchart for the selection of studies, according to PRISMA recommendation (14) The selected studies were classified according to the level of evidence (16) , which were seven: 1) evidence presented in a systematic review or meta--analysis of randomized controlled clinical trials or clinical guidelines based on systematic reviews of randomized controlled trials; 2) evidence from a randomized controlled trial; 3) evidence from clinical trials without randomization; 4) evidence from cohort and case-control studies; 5) evidence from systematic review of descriptive and qualitative studies; 6) evidence of a single descriptive or qualitative study; 7) evidence from opinion of authorities and/or report of expert committees.…”

“…Quantitative approach was used in 100.0% of the studies. There was prevalence of prospective cohort studies, in seven out of the eight articles(87.5%) (17)(18)(19)(20)(21)(22)(23) , and only a prospective descriptive observational study (12.5%) (24) , which shows a predominantly longitudinal prospective profile chosen for the evaluation of the quality of life of individuals. Thus, the articles selected indicate, in great majority, level of evidence 4, and although presenting average scientific evidence, according to the reference adopted in this study (16) , they constitute the most appropriate methodological design to be used in long-term lifestyle monitoring and/or personal satisfaction investigations.…”

“…The follow-up period of patients undergoing myocardial revascularization and the data collection on quality of life ranged from the preoperative period up to 12 months postoperatively. One study evaluated the moments of 5-7 days after surgery (10) , as well as 6 and 10 weeks (20) ; another evaluated the moments 1 and 3 months after surgery (23) ; however, the evaluation periods that stood out were 6 months after surgery, adopted in three studies (17)(18)(19) , and 12 months, also adopted in three other studies (21)(22)24) .…”

“…In this review, the type of instruments applied varied. Three articles used the SF-36 (Short-Form-36) instrument (17,19,24) , which is a widely used instrument in researches to obtain objective data on quality of life, with 36 questions addressing the general health status in domains that address physical function, physical components, body pain, general health, vitality, social function, emotional role and mental health; one article used a short version of SF-36, called the SF-12 (Short Form-12) (18) , with 12 easy-to-apply questions, covering the eight domains of the SF-36, but summarizing the domains in two topics, namely "summary of physical components" and "summary of mental components"; two articles derived from an original scientific study developed in Finland, in which quality of life is assessed with reference values targeting the Finnish population, applied the RAND-36 instrument (21)(22) , which covers eight domains, such as general health, physical function, physical component, body pain, emotional well-being, emotional component, social function and energy; one study used the MacNew QoL scale (20) , related to heart disease, with 27 questions that cover emotional characteristics of individuals in 14 questions, as well as physical and social characteristics in 13 questions; and one article applied the cardiac version of the Quality of Life Index (QLI) instrument (23) , which addresses 32 items in four subscales of functional capacity and health, socioeconomic components, psychological/spiritual components, and family.…”