Psychological risk factors for cardiac-related hospital readmission within 6 months of coronary artery bypass graft surgery

被引:63
作者
Oxlad, Melissa
Stubberfield, John
Stuklis, Robert
Edwards, James
Wade, Tracey D.
机构
[1] Flinders Univ S Australia, Sch Psychol, Adelaide, SA 5001, Australia
[2] Royal Adelaide Hosp, Cardiothorac Unit, Adelaide, SA 5000, Australia
关键词
depression; anxiety; posttraumatic stress disorder; coronary artery bypass graft surgery; readmission;
D O I
10.1016/j.jpsychores.2006.09.008
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Objective: The objective of this study was to examine the psychological risk factors for cardiac-related readmission within 6 months of coronary artery bypass graft surgery (CABG). Methods: Consecutive patients awaiting elective CABG (N=119; 100 males and 19 females), with a mean age of 63.3 years, completed a battery of psychosocial measures in a three-stage repeated-measures design. Relevant medical data were also extracted from patients' medical records 6 months postoperatively to allow for the examination of potential covariates. Results: Two psychological variables, increased postoperative anxiety and increased preoperative depression, were identified as risk factors for cardiac-related readmission independent of the only significant covariate identified, cardiopulmonary bypass time. Conclusion: Anxiety in the immediate postoperative period and, to a lesser extent, preoperative depression are important determinants of health care utilization postdischarge. Further research to clarify the psychological factors that are predictive of readmission, and that attempt to determine both the underlying cause of readmissions and potential mechanisms through which psychological factors act is recommended. Such research may highlight potential factors to target in interventions and the best time at which to intervene. (c) 2006 Elsevier Inc. All rights reserved.
引用
收藏
页码:775 / 781
页数:7
相关论文
共 22 条
[1]   Mood state as a predictor of neuropsychological deficits following cardiac surgery [J].
Andrew, MJ ;
Baker, RA ;
Kneebone, AC ;
Knight, JL .
JOURNAL OF PSYCHOSOMATIC RESEARCH, 2000, 48 (06) :537-546
[2]  
Australian Institute of Health and Welfare (AIHW), 2004, AUSTR HLTH 2004
[3]   Preoperative depression and mortality in coronary artery bypass surgery: Preliminary findings [J].
Baker, RA ;
Andrew, MJ ;
Schrader, G ;
Knight, JL .
AUSTRALIAN AND NEW ZEALAND JOURNAL OF SURGERY, 2001, 71 (03) :139-142
[4]   Personality, social context and cognitive predictors of post-traumatic stress disorder in myocardial infarction patients [J].
Bennett, P ;
Owen, RL ;
Koutsakis, S ;
Bisson, J .
PSYCHOLOGY & HEALTH, 2002, 17 (04) :489-500
[5]   Presurgical depression predicts medical morbidity 6 months after coronary artery bypass graft surgery [J].
Burg, MM ;
Benedetto, MC ;
Rosenberg, R ;
Soufer, R .
PSYCHOSOMATIC MEDICINE, 2003, 65 (01) :111-118
[6]   DEPRESSION AS A RISK FACTOR FOR CARDIAC EVENTS IN ESTABLISHED CORONARY HEART-DISEASE - A REVIEW OF POSSIBLE MECHANISMS [J].
CARNEY, RM ;
FREEDLAND, KE ;
RICH, MW ;
JAFFE, AS .
ANNALS OF BEHAVIORAL MEDICINE, 1995, 17 (02) :142-149
[7]   Relation between depression after coronary artery bypass surgery and 12-month outcome: a prospective study [J].
Connerney, I ;
Shapiro, PA ;
McLaughlin, JS ;
Bagiella, E ;
Sloan, RP .
LANCET, 2001, 358 (9295) :1766-1771
[8]   The validation of a self-report measure of posttraumatic stress disorder: The Posttraumatic Diagnostic Scale [J].
Foa, EB ;
Cashman, L ;
Jaycox, L ;
Perry, K .
PSYCHOLOGICAL ASSESSMENT, 1997, 9 (04) :445-451
[9]   DEPRESSION FOLLOWING MYOCARDIAL-INFARCTION - IMPACT ON 6-MONTH SURVIVAL [J].
FRASURESMITH, N ;
LESPERANCE, F ;
TALAJIC, M .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1993, 270 (15) :1819-1825
[10]   Predicting completeness of symptom relief after major heart surgery [J].
Jenkins, CD ;
Jono, RT ;
Stanton, BA .
BEHAVIORAL MEDICINE, 1996, 22 (02) :45-57