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Psychiatric and psychosocial outcome of cardiac surgery with cardiopulmonary bypass: a prospective 12-month follow-up study.
Gen Hosp Psychiatry. 2005 Jan-Feb; 27(1):18-28.GH

Abstract

Little is known concerning the natural history of psychiatric morbidity, postoperative delirium, cognitive decline and health-related quality of life (HRQOL) in cardiac surgery patients and the impact of neurocognitive dysfunction on HRQOL after cardiac surgery with cardiopulmonary bypass (CPB). In a prospective study, we followed up for 1 year 30 of the original 34 patients who had undergone cardiac surgery with CPB. Patients were assessed preoperatively, before discharge, and at 1 year after surgery with the Structural Clinical Interview for DSM-IV and a series of neuropsychological tests. Psychometric scales were administered to evaluate cognitive functioning (Syndrom Kurztest), depressive symptomatology (Montgomery-Asberg Depression Rating Scale), posttraumatic stress symptoms (Posttraumatic Stress Syndrome 10-Questions Inventory) and HRQOL (SF-36 Health Status Questionnaire). Delirium Rating Scale (DRS) was used daily over the course of intensive care unit treatment. Postoperative delirium developed in 11 of the 34 patients (mean DRS rating scale score+/-S.D.: 20.36+/-6.22, range: 14-31). Short-term consequences of cardiac surgery included adjustment disorder with depressed features (n=11), posttraumatic stress disorder (n=6), major depression (n=6) and clinically relevant cognitive deficits (n=13). At 12 months, the severity of depression and anxiety disorders improved and returned to the preoperative level, and 6 out of the 30 followed-up patients displayed cognitive deficits. Our patients' HRQOL SF-36 self-reports significantly improved compared with baseline quality of life data. However, 1-year overall lower cognitive function scores were associated with lower HRQOL. Cardiac surgery with CPB is associated with improvements in HRQOL relative to the preoperative period, but the presence of cardiac surgery-related cognitive decline impairing HRQOL is a complication for a subgroup of cardiac surgical patients in the long-term outcome.

Authors+Show Affiliations

Department of Psychiatry, University of Medicine of Graz, A-8036 Graz, Austria. bans-bernd.rothenhaeusler@klinikum-graz.atNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15694215

Citation

Rothenhäusler, Hans-Bernd, et al. "Psychiatric and Psychosocial Outcome of Cardiac Surgery With Cardiopulmonary Bypass: a Prospective 12-month Follow-up Study." General Hospital Psychiatry, vol. 27, no. 1, 2005, pp. 18-28.
Rothenhäusler HB, Grieser B, Nollert G, et al. Psychiatric and psychosocial outcome of cardiac surgery with cardiopulmonary bypass: a prospective 12-month follow-up study. Gen Hosp Psychiatry. 2005;27(1):18-28.
Rothenhäusler, H. B., Grieser, B., Nollert, G., Reichart, B., Schelling, G., & Kapfhammer, H. P. (2005). Psychiatric and psychosocial outcome of cardiac surgery with cardiopulmonary bypass: a prospective 12-month follow-up study. General Hospital Psychiatry, 27(1), 18-28.
Rothenhäusler HB, et al. Psychiatric and Psychosocial Outcome of Cardiac Surgery With Cardiopulmonary Bypass: a Prospective 12-month Follow-up Study. Gen Hosp Psychiatry. 2005 Jan-Feb;27(1):18-28. PubMed PMID: 15694215.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Psychiatric and psychosocial outcome of cardiac surgery with cardiopulmonary bypass: a prospective 12-month follow-up study. AU - Rothenhäusler,Hans-Bernd, AU - Grieser,Bernhard, AU - Nollert,Georg, AU - Reichart,Bruno, AU - Schelling,Gustav, AU - Kapfhammer,Hans-Peter, PY - 2004/01/26/received PY - 2004/09/08/accepted PY - 2005/2/8/pubmed PY - 2005/6/2/medline PY - 2005/2/8/entrez SP - 18 EP - 28 JF - General hospital psychiatry JO - Gen Hosp Psychiatry VL - 27 IS - 1 N2 - Little is known concerning the natural history of psychiatric morbidity, postoperative delirium, cognitive decline and health-related quality of life (HRQOL) in cardiac surgery patients and the impact of neurocognitive dysfunction on HRQOL after cardiac surgery with cardiopulmonary bypass (CPB). In a prospective study, we followed up for 1 year 30 of the original 34 patients who had undergone cardiac surgery with CPB. Patients were assessed preoperatively, before discharge, and at 1 year after surgery with the Structural Clinical Interview for DSM-IV and a series of neuropsychological tests. Psychometric scales were administered to evaluate cognitive functioning (Syndrom Kurztest), depressive symptomatology (Montgomery-Asberg Depression Rating Scale), posttraumatic stress symptoms (Posttraumatic Stress Syndrome 10-Questions Inventory) and HRQOL (SF-36 Health Status Questionnaire). Delirium Rating Scale (DRS) was used daily over the course of intensive care unit treatment. Postoperative delirium developed in 11 of the 34 patients (mean DRS rating scale score+/-S.D.: 20.36+/-6.22, range: 14-31). Short-term consequences of cardiac surgery included adjustment disorder with depressed features (n=11), posttraumatic stress disorder (n=6), major depression (n=6) and clinically relevant cognitive deficits (n=13). At 12 months, the severity of depression and anxiety disorders improved and returned to the preoperative level, and 6 out of the 30 followed-up patients displayed cognitive deficits. Our patients' HRQOL SF-36 self-reports significantly improved compared with baseline quality of life data. However, 1-year overall lower cognitive function scores were associated with lower HRQOL. Cardiac surgery with CPB is associated with improvements in HRQOL relative to the preoperative period, but the presence of cardiac surgery-related cognitive decline impairing HRQOL is a complication for a subgroup of cardiac surgical patients in the long-term outcome. SN - 0163-8343 UR - https://www.unboundmedicine.com/medline/citation/15694215/Psychiatric_and_psychosocial_outcome_of_cardiac_surgery_with_cardiopulmonary_bypass:_a_prospective_12_month_follow_up_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0163-8343(04)00110-0 DB - PRIME DP - Unbound Medicine ER -