Social and emotional factors as predictors of poor outcomes following cardiac surgery
Autor: | Philip Moons, Lau Caspar Thygesen, Samer A.M. Nashef, Selina Kikkenborg Berg, Pernille Fevejle Cromhout, Sune Damgaard |
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Jazyk: | angličtina |
Rok vydání: | 2022 |
Předmět: |
Adult
Pulmonary and Respiratory Medicine medicine.medical_specialty Risk Assessment law.invention law Intensive care medicine Humans Cardiac Surgical Procedures Risk assessment Adult Cardiac AcademicSubjects/MED00920 business.industry EuroSCORE Original Articles Odds ratio Length of Stay Cardiac surgery Intensive care unit Confidence interval Intensive Care Units Risk factors Emergency medicine Anxiety Surgery medicine.symptom Cardiology and Cardiovascular Medicine business |
Zdroj: | Cromhout, P F, Thygesen, L C, Moons, P, Nashef, S, Damgaard, S & Berg, S K 2022, ' Social and emotional factors as predictors of poor outcomes following cardiac surgery ', Interactive Cardiovascular and Thoracic Surgery, vol. 34, no. 2, pp. 193–200 . https://doi.org/10.1093/icvts/ivab261 Interactive Cardiovascular and Thoracic Surgery Cromhout, P F, Thygesen, L C, Moons, P, Nashef, S, Damgaard, S & Berg, S K 2022, ' Social and emotional factors as predictors of poor outcomes following cardiac surgery ', Interactive Cardiovascular and Thoracic Surgery, vol. 34, no. 2, pp. 193-200 . https://doi.org/10.1093/icvts/ivab261 |
Popis: | OBJECTIVES Existing risk prediction models in cardiac surgery stratify individuals based on their predicted risk, including only medical and physiological factors. However, the complex nature of risk assessment and the lack of parameters representing non-medical aspects of patients’ lives point towards the need for a broader paradigm in cardiac surgery. Objectives were to evaluate the predictive value of emotional and social factors on 4 outcomes; death within 90 days, prolonged stay in intensive care (≥72 h), prolonged hospital admission (≥10 days) and readmission within 90 days following cardiac surgery, as a supplement to traditional risk assessment by European System for Cardiac Operative Risk Evaluation (EuroSCORE). METHODS The study included adults undergoing cardiac surgery in Denmark 2014–2017 including information on register-based socio-economic factors, and, in a nested subsample, self-reported symptoms of anxiety and depression. Logistic regression analyses were conducted, adjusted for EuroSCORE, of variables reflecting social and emotional factors. RESULTS Amongst 7874 included patients, lower educational level (odds ratio 1.33; 95% confidence interval 1.17–1.51) and living alone (1.25; 1.14–1.38) were associated with prolonged hospital admission after adjustment for EuroSCORE. Lower educational level was also associated with prolonged intensive care unit stay (1.27; 1.00–1.63). Having a high income was associated with decreased odds of prolonged hospital admission (0.78; 0.70–0.87). No associations or predictive value for symptoms of anxiety or depression were found on any outcomes. CONCLUSIONS Social disparity is predictive of poor outcomes following cardiac surgery. Symptoms of anxiety and depression are frequent especially amongst patients with a high-risk profile according to EuroSCORE. Subj collection 105, 123 Cardiac surgical procedures are being offered to older, more complex and high-risk patients than earlier. |
Databáze: | OpenAIRE |
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