Preoperative psychological distress is associated with mortality within 1 year of non-cardiac surgery

IF 3.7 2区 医学 Q1 PSYCHIATRY
Renée El-Gabalawy , Jordana L Sommer , Jitender Sareen , Corey S Mackenzie , P.J. Devereaux , Kailey Penner , Sadeesh Srinathan
{"title":"Preoperative psychological distress is associated with mortality within 1 year of non-cardiac surgery","authors":"Renée El-Gabalawy ,&nbsp;Jordana L Sommer ,&nbsp;Jitender Sareen ,&nbsp;Corey S Mackenzie ,&nbsp;P.J. Devereaux ,&nbsp;Kailey Penner ,&nbsp;Sadeesh Srinathan","doi":"10.1016/j.genhosppsych.2025.04.002","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>To characterize the association between preoperative psychological distress and postoperative complications at 30 days and mortality at 1 year in a non-cardiac surgery sample.</div></div><div><h3>Method</h3><div>Data were taken from a subsample of the VISION cohort study (<em>n</em> = 997; 2011–2012). Participants were scheduled to undergo major non-cardiac surgery under general or regional anesthesia. Participants self-reported past 30-day psychological distress on the day of surgery using the Kessler-6 (K6) Scale. Complications were assessed via interviews and/or chart reviews. Multivariable logistic regressions characterized the relationship between preoperative psychological distress and postoperative complications. Models were fitted for sociodemographics, surgery type, preoperative medical morbidity, and smoking.</div></div><div><h3>Results</h3><div>Among participants with a completed K6 (<em>n</em> = 938), 7.9 % experienced mortality within 1 year. After controlling for age, ethnicity, sex, surgery type, preoperative medical morbidity, and smoking, higher levels of preoperative psychological distress were associated with 30 day complications such as myocardial infarction, non-fatal cardiac arrest, leg/arm deep vein thrombosis/ pulmonary embolism, new acute renal failure, pneumonia, and congestive heart failure (AOR3 (3rd model), 1.12, [95 % CI, 1.02–1.22, <em>p</em> &lt; 0.05]) and 1-year mortality (AOR3, 1.09, [95 % CI, 1.02–1.18, p &lt; 0.05]). Sensitivity analyses demonstrate that the latter association was being driven by symptoms of depression (AOR3, 1.17 [95 % CI 1.04–1.33, p &lt; 0.05]) but not anxiety (AOR2, 0.94 [95 % CI, 0.61–1.62, <em>p</em> &gt; 0.05]).</div></div><div><h3>Conclusion</h3><div>Elevated preoperative distress increased the risk of 30-day complications and mortality at 1 year. These results underscore the need for future research to examine if supporting patients' mental health during the perioperative period can mitigate risk.</div><div><strong>Clinical Trial Registration</strong>: <span><span>clinicaltrials.gov</span><svg><path></path></svg></span>, no. <span><span>NCT00512109</span><svg><path></path></svg></span> (main VISION study).</div></div>","PeriodicalId":12517,"journal":{"name":"General hospital psychiatry","volume":"95 ","pages":"Pages 25-31"},"PeriodicalIF":3.7000,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"General hospital psychiatry","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0163834325000908","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}
引用次数: 0

Abstract

Objective

To characterize the association between preoperative psychological distress and postoperative complications at 30 days and mortality at 1 year in a non-cardiac surgery sample.

Method

Data were taken from a subsample of the VISION cohort study (n = 997; 2011–2012). Participants were scheduled to undergo major non-cardiac surgery under general or regional anesthesia. Participants self-reported past 30-day psychological distress on the day of surgery using the Kessler-6 (K6) Scale. Complications were assessed via interviews and/or chart reviews. Multivariable logistic regressions characterized the relationship between preoperative psychological distress and postoperative complications. Models were fitted for sociodemographics, surgery type, preoperative medical morbidity, and smoking.

Results

Among participants with a completed K6 (n = 938), 7.9 % experienced mortality within 1 year. After controlling for age, ethnicity, sex, surgery type, preoperative medical morbidity, and smoking, higher levels of preoperative psychological distress were associated with 30 day complications such as myocardial infarction, non-fatal cardiac arrest, leg/arm deep vein thrombosis/ pulmonary embolism, new acute renal failure, pneumonia, and congestive heart failure (AOR3 (3rd model), 1.12, [95 % CI, 1.02–1.22, p < 0.05]) and 1-year mortality (AOR3, 1.09, [95 % CI, 1.02–1.18, p < 0.05]). Sensitivity analyses demonstrate that the latter association was being driven by symptoms of depression (AOR3, 1.17 [95 % CI 1.04–1.33, p < 0.05]) but not anxiety (AOR2, 0.94 [95 % CI, 0.61–1.62, p > 0.05]).

Conclusion

Elevated preoperative distress increased the risk of 30-day complications and mortality at 1 year. These results underscore the need for future research to examine if supporting patients' mental health during the perioperative period can mitigate risk.
Clinical Trial Registration: clinicaltrials.gov, no. NCT00512109 (main VISION study).
术前心理困扰与非心脏手术1年内的死亡率相关
目的探讨非心脏手术患者术前心理困扰与术后30天并发症及1年死亡率之间的关系。方法数据取自VISION队列研究的子样本(n = 997;2011 - 2012)。参与者被安排在全身或局部麻醉下接受重大非心脏手术。参与者在手术当天使用Kessler-6 (K6)量表自我报告过去30天的心理困扰。通过访谈和/或图表评估并发症。多变量logistic回归分析了术前心理困扰与术后并发症的关系。模型拟合了社会人口统计学、手术类型、术前医疗发病率和吸烟情况。在完成K6的参与者中(n = 938), 7.9%的人在1年内死亡。在控制年龄、种族、性别、手术类型、术前医疗发病率和吸烟后,较高水平的术前心理困扰与30天并发症相关,如心肌梗死、非致死性心脏骤停、腿/手臂深静脉血栓形成/肺栓塞、新发急性肾功能衰竭、肺炎和充血性心力衰竭(AOR3(第3模型),1.12,[95% CI, 1.02-1.22, p <;0.05])和1年死亡率(AOR3, 1.09, [95% CI, 1.02-1.18, p <;0.05])。敏感性分析表明,后一种关联是由抑郁症状驱动的(AOR3, 1.17) [95% CI 1.04-1.33, p <;0.05]),但没有焦虑(AOR2, 0.94 [95% CI, 0.61-1.62, p >;0.05])。结论术前焦虑升高可增加术后30天并发症及1年死亡率。这些结果强调了未来研究的必要性,以检验在围手术期支持患者的心理健康是否可以降低风险。临床试验注册:clinicaltrials.gov,编号;NCT00512109(主视觉研究)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
General hospital psychiatry
General hospital psychiatry 医学-精神病学
CiteScore
9.60
自引率
2.90%
发文量
125
审稿时长
20 days
期刊介绍: General Hospital Psychiatry explores the many linkages among psychiatry, medicine, and primary care. In emphasizing a biopsychosocial approach to illness and health, the journal provides a forum for professionals with clinical, academic, and research interests in psychiatry''s role in the mainstream of medicine.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信