Preoperative anxiety as predictor of perioperative clinical events following carotid surgery: a prospective observational study

Perioperative Medicine

Florian Primavesi¹  Thomas J. Hölzenbein¹  Florian K. Enzmann¹  Patrick Nierlich¹  Reinald Seitelberger¹  Lucia Algayerova¹  Manuela Aspalter¹  Klaus Linni¹  Christoph Kartnig²  Wolfgang Hitzl³ 

[1] Department of Cardiac, Vascular and Endovascular Surgery, Paracelsus Medical University, Müllner Hauptstraße 48, 5020, Salzburg, Austria;Department of Psychiatry, Division of Psychosomatic Medicine, Paracelsus Medical University, Müllner Hauptstraße 48, 5020, Salzburg, Austria;Research Office, Biostatistics, Paracelsus Medical University, Strubergasse 21, 5020, Salzburg, Austria;Department of Ophthalmology and Optometry, Paracelsus Medical University Salzburg, Müllner Hauptstr. 48, 5020, Salzburg, Austria;Research Program Experimental Ophthalmology and Glaucoma Research, Paracelsus Medical University, Muellner Hauptstrasse 48, 5020, Salzburg, Austria;

关键词: Asymptomatic carotid artery stenosis;    Carotid endarterectomy;    Hospital anxiety and depression scale;    Spielberger state and trait anxiety inventory;   

DOI  :  10.1186/s13741-021-00223-2

来源: Springer

【 摘 要 】

BackgroundPsychological 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.MethodsSingle 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.ResultsFrom 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).ConclusionsThe 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.

【 授权许可】

CC BY