Association between preoperative depression and long-term survival following coronary artery bypass surgery - A systematic review and meta-analysis

作者：Stenman Malin^*; Holzmann Martin J; Sartipy Ulrik

来源：International Journal of Cardiology, 2016, 222: 462-466.

DOI：10.1016/j.ijcard.2016.07.216

• Depression
• Coronary artery bypass grafting
• Survival
• Meta-analysis
• Systematic review

Background: Depression is common in patients with cardiovascular disease. The importance of preoperative depression for long-termsurvival following coronary artery bypass grafting (CABG) is not well known. The aim was to provide a summary estimate of the association between preoperative depression and long-term survival in adults who underwent CABG.
Methods: We did a systematic search of MEDLINE, EMBASE, Cochrane Library, PsycINFO, Web of Science, and PubMed from inception to November, 2015, including cohort studies with at least one month of follow-up that reported hazard ratios (HR) and 95% confidence intervals (CI) for long-term all-cause mortality following CABG in patients with preoperative depression compared to non-depressed patients. Two reviewers independently extracted data on populations, exposure, outcome, risk of bias, and quality of evidence. We calculated HR and 95% CIs for all-cause mortality using random-effects meta-analyses and performed subgroup and sensitivity analyses.
Results: Seven studies were included with a combined study population of 89,490 patients (4002 depressed/85,488 non-depressed). All studies observed a positive association between preoperative depression and allcause mortality, and in 4 studies the association was statistically significant. Patients with depression had a pooled hazard ratio of 1.46 (95% CI: 1.23-1.73, p < 0.0001) for all-cause mortality with moderate heterogeneity (I-2 = 50.1%, p = 0.061).
Conclusions: This systematic reviewandmeta-analysis indicates that patients with preoperative depression are at increased risk for long-term, all-cause mortality following CABG compared with those without depression. Systematic screening for depression prior to cardiac surgery could identify those at higher risk.

• 出版日期2016-11-1