TY - JOUR
T1 - Increased psychiatric morbidity after abdominal aortic surgery
T2 - Risk factors for stress-related disorders
AU - Liberzon, Israel
AU - Abelson, James L.
AU - Amdur, Richard L.
AU - King, Anthony P.
AU - Cardneau, Jeffry D.
AU - Henke, Peter
AU - Graham, Linda M.
N1 - Funding Information:
Supported by the Department of Veterans Affairs Medical Research Advanced Career Development Award (I.L.) and the National Institute of Mental Health (I.L.; RO1 MH063092).
PY - 2006/5
Y1 - 2006/5
N2 - Objective: Research on surgical outcomes has focused on technical results and physical morbidity. However, postoperative psychiatric complications are common and can undermine functional results. High rates of posttraumatic stress disorder and major depressive disorder have been documented after cardiac events or surgery. These complications are also expected after abdominal aortic surgery, but their incidence and relevant risk factors in this population have not been documented. Methods: We examined the development of posttraumatic stress and depressive symptoms in patients with aortic aneurysms or occlusive disease, comparing surgical with nonsurgical patients and predicting that surgery and a prolonged intensive care stay would contribute to the development of psychiatric morbidity. A consecutive sample of vascular surgery patients (n = 109) was recruited 6 months to 2 years after surgery. Data were analyzed by using group comparisons, regression, and path analyses. Results: Rates of objectively determined postoperative psychiatric morbidity were extremely high (32%). Surgical patients were more than four times more likely to develop psychiatric disorders (odds ratio, 4.8; P = .02). Being younger, having increased preoperative blood pressure, and being intubated at the end of surgery were linked to greater rates of psychiatric morbidity (P < .05), but a longer intensive care stay was not. Conclusions: New-onset psychiatric symptoms are common after abdominal aortic surgery, and preoperative and surgical factors were more predictive than postoperative complications and stress, as reflected in intensive care unit stays. Prospective examination of vulnerability in this model could identify risk factors for stress-related psychiatric morbidity and help improve surgical outcomes.
AB - Objective: Research on surgical outcomes has focused on technical results and physical morbidity. However, postoperative psychiatric complications are common and can undermine functional results. High rates of posttraumatic stress disorder and major depressive disorder have been documented after cardiac events or surgery. These complications are also expected after abdominal aortic surgery, but their incidence and relevant risk factors in this population have not been documented. Methods: We examined the development of posttraumatic stress and depressive symptoms in patients with aortic aneurysms or occlusive disease, comparing surgical with nonsurgical patients and predicting that surgery and a prolonged intensive care stay would contribute to the development of psychiatric morbidity. A consecutive sample of vascular surgery patients (n = 109) was recruited 6 months to 2 years after surgery. Data were analyzed by using group comparisons, regression, and path analyses. Results: Rates of objectively determined postoperative psychiatric morbidity were extremely high (32%). Surgical patients were more than four times more likely to develop psychiatric disorders (odds ratio, 4.8; P = .02). Being younger, having increased preoperative blood pressure, and being intubated at the end of surgery were linked to greater rates of psychiatric morbidity (P < .05), but a longer intensive care stay was not. Conclusions: New-onset psychiatric symptoms are common after abdominal aortic surgery, and preoperative and surgical factors were more predictive than postoperative complications and stress, as reflected in intensive care unit stays. Prospective examination of vulnerability in this model could identify risk factors for stress-related psychiatric morbidity and help improve surgical outcomes.
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U2 - 10.1016/j.jvs.2006.01.026
DO - 10.1016/j.jvs.2006.01.026
M3 - Article
C2 - 16678685
AN - SCOPUS:33646148479
VL - 43
SP - 929
EP - 934
JO - Journal of Vascular Surgery
JF - Journal of Vascular Surgery
SN - 0741-5214
IS - 5
ER -