Depression, anxiety disorders and Type D personality as risk factors for delirium after cardiac surgery

作者：Tully Phillip J^*; Baker Robert A; Eld Helen R Winefi; Turnbull Deborah A

来源：Australian and New Zealand Journal of Psychiatry, 2010, 44(11): 1005-1011.

• coronary artery bypass grafts
• delirium
• major depression
• panic disorder
• Type D personality

Objectives: To determine the prognostic risk of incident delirium after cardiac surgery attributable to preoperative affective disorders and Type D personality.
Methods: Patients awaiting elective coronary revascularization surgery (N = 158; 20.9% female; 11.4% concomitant valve surgery; age M = 64.7, SD = 10.6) underwent the structured MINI International Neuropsychiatric Interview and completed a measure of Type D personality. Postoperative incident delirium was established prior to discharge from the index hospitalization with structured psychiatric interview.
Results: The prevalence of psychiatric disorders before cardiac surgery was 17.1% for major depression, 7.6% for panic disorder, 10.1% for generalized anxiety disorder, and 13.3% for Type D personality, while there were 49 (31% of total) cases of delirium after surgery. After adjustment for sex, older age, cross-clamp time, haemoglobin (Hb) and psychotropic drug use, major depression was significantly associated with delirium, odds ratio (OR) = 3.86 (95% confidence interval (CI) 1.42 to 10.52, p = 0.001). Adjustment for clinical covariates suggested that Type D personality was not significantly associated with delirium, OR = 2.85 (95% CI 0.97 to 8.38, p = 0.06).
Conclusions: Major depression was significantly associated with incident delirium after cardiac surgery. These findings suggest that the risk of incident delirium attributable to major depression was not merely a reflection of common diagnostic features in prospectively examined cardiac surgery patients.

• 出版日期2010-11