Preoperative anxiety as predictor of perioperative clinical events following carotid surgery: a prospective observational study.
Preoperative anxiety as predictor of perioperative clinical events following carotid surgery: a prospective observational study.
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DOI：
10.1186/s13741-021-00223-2
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发表时间：
2021-12-08
期刊：
影响因子：
--
通讯作者：
Linni K
中科院分区：
文献类型：
--
作者：
Aspalter M;Enzmann FK;Hölzenbein TJ;Hitzl W;Primavesi F;Algayerova L;Nierlich P;Kartnig C;Seitelberger R;Linni K
焦虑和抑郁等心理因素被认为在心血管疾病的发展中起着因果作用，它们也可能影响血管外科手术后的结果。本研究的目的是调查择期颈动脉手术后焦虑和抑郁与术后结果的关系。在学术血管外科中心接受无症状颈动脉狭窄治疗的患者的单中心前瞻性观察研究。术前采用Spielberger状态-特质焦虑量表（STAI-S/-T）和医院焦虑抑郁量表（HADS-A/-D）进行焦虑和抑郁的自评。术后发病率和死亡率通过卒中、心肌梗死（MI）和死亡的主要复合终点进行评估。应用颈动脉疾病的标准报告指南。从2012年6月至2015年11月，在我们机构进行了393例颈动脉内膜切除术（CEA）。其中，98例无症状患者可用于分析（78%为男性;中位年龄为71.1岁）。自我报告问卷的中位数得分与一般人群的已发表数据没有差异（STAI-T，特质成分，中位数，36; IQR，31-42.75; STAI-S，状态成分，中位数，3 - 8; IQR，32-43; HADS-A中位数，6; IQR，3-8; HADS-D中位数，4; IQR，2-7）。心血管危险因素在焦虑和非焦虑患者中相似。卒中、MI和死亡的复合终点在术前HADS-A评分高于6分的患者中发生率显著更高（10.5%，95% CI，3-25; p = 0.020）。目前的研究表明，术前焦虑与发生内和术后神经系统事件的患者接受CEA。术前HADS-A评分为6分或更低的患者发生这些并发症的概率非常低。
Psychological factors like anxiety and depression are recognised to play a causal role in the development of cardiovascular disease and they may also influence outcome after vascular surgery procedures. The aim of this study was to investigate the association of anxiety and depression with postoperative outcome following elective carotid surgery. Single centre prospective observational study of patients treated for asymptomatic carotid artery stenosis at an academic vascular surgery centre. Preoperative anxiety and depression were evaluated using self-reporting questionnaires: Spielberger State-Trait Anxiety Inventory (STAI-S/-T) and Hospital Anxiety and Depression Scale (HADS-A/-D). Postoperative morbidity and mortality were assessed with the primary composite endpoint of stroke, myocardial infarction (MI) and death. Standard reporting guidelines for carotid disease were applied. From June 2012 to November 2015, 393 carotid endarterectomies (CEA) were performed at our institution. Out of those, 98 asymptomatic patients were available for analysis (78% male; median age, 71.1 years). Median scores of self-reporting questionnaires did not differ from published data of the general population (STAI-T, trait component, median, 36; IQR, 31-42.75; STAI-S, state component, median, 38; IQR, 32-43; HADS-A median, 6; IQR, 3-8; HADS-D median, 4; IQR, 2-7). Cardiovascular risk factors were similar in anxious and non-anxious patients. The composite endpoint of stroke, MI and death occurred significantly more often in patients presenting with a preoperative HADS-A score higher than 6 (10.5%, 95% CI, 3-25; p =.020). The present study indicates that preoperative anxiety is associated with the occurrence of intra- and postoperative neurological events in patients undergoing CEA. Patients who had a preoperative HADS-A score of 6 or less had a very low probability of experiencing these complications.
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