Improving Depression Detection and Measuring Its Impact Upon Short-Term Survival in Chronic Limb-Threatening Ischemia (CLTI).

IF 1.4 4区医学 Q3 PERIPHERAL VASCULAR DISEASE

Annals of vascular surgery Pub Date : 2025-03-11 DOI:10.1016/j.avsg.2025.02.015

Cuneyt Koksoy, Ilse Torres, Xin Yee Ooi, Zachary S Pallister, Ramyar Gilani, Joseph L Mills, Jayer Chung

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引用次数: 0

Abstract

Background: Depression is underdiagnosed in chronic limb-threatening ischemia (CLTI) patients, and its impact on outcomes is unclear. This study aims to evaluate a CLTI-specific questionnaire designed to detect depression and anxiety, as well as to quantify its impact on early outcomes.

Methods: A serial cross-sectional study was conducted over two four-month periods: Block I, which retrospectively examined depression prevalence based on medical records, and Block II, which prospectively assessed depression using a CLTI-specific questionnaire. Patients were followed for six months to assess early outcomes. Data on demographics, comorbidities, Wound, Ischemia, foot Infection (WIfI) grades, perioperative and six-month limb salvage, and survival were collected and analyzed.

Results: We evaluated 101 CLTI patients (58 in Block I; 43 in Block II; median age 68 years [IQR 62-74]; 67 [66.3%] male). In Block I, 20.7% had a prior depression diagnosis; in Block II, 23.3% (p=0.76). The CLTI-specific questionnaire in Block II showed a median depression score of 22 (IQR 19-33), identifying 32.6% with moderate/severe depression and 11.9% more patients compared to chart review alone. Active smoking (Hazard Ratio [HR] 5.16, 95% Confidence Interval [CI] 1.9-14.1) and WIfI clinical stage 4 (HR 4.69, 95% CI 1.39-15.75) were significantly associated with depression. At six months, patients with depression had higher rates of major amputation (18.2% vs. 4.0%; p=0.02) and mortality (27.3% vs. 6.3%; p<0.01).

Conclusion: The overall prevalence of depression in CLTI patients is 32.6%. Our novel CLTI-specific questionnaire detects 12% more cases of moderate/severe depression compared to chart review alone. Depression was linked to higher six-month mortality, though confounders like smoking and WIfI stage 4 may contribute. Identifying and treating depression in high-risk CLTI patients could improve outcomes.

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来源期刊

Annals of vascular surgery 医学-外科

CiteScore

3.00

自引率

13.30%

发文量

603

审稿时长

50 days

期刊介绍： Annals of Vascular Surgery, published eight times a year, invites original manuscripts reporting clinical and experimental work in vascular surgery for peer review. Articles may be submitted for the following sections of the journal: Clinical Research (reports of clinical series, new drug or medical device trials) Basic Science Research (new investigations, experimental work) Case Reports (reports on a limited series of patients) General Reviews (scholarly review of the existing literature on a relevant topic) Developments in Endovascular and Endoscopic Surgery Selected Techniques (technical maneuvers) Historical Notes (interesting vignettes from the early days of vascular surgery) Editorials/Correspondence