Clinical ResearchImpact of Physical Activity on Depression After Cardiac Surgery
Section snippets
Methods
From May 2010-August 2011, 436 consecutively consenting patients undergoing elective cardiac surgery or awaiting in-hospital cardiac surgery requiring cardiopulmonary bypass (CPB) were recruited. Enrolled patients were assessed for short-term depression and physical activity behaviour preoperatively (Q1), at hospital discharge (Q2), and 3 months (Q3) and 6 months (Q4) postoperatively (Fig. 1). The study was approved by the University of Manitoba Research Ethics Board and the St. Boniface
Depression
The prevalence of depression increased significantly preoperatively to the time of discharge (Fig. 2), which resulted from an incidence of new depression of 29%,12 whereas 58% and 28% of the “at risk” and “naive” subgroups became depressed at discharge, respectively (Fig. 2). Although the prevalence of depression in the whole study population decreased to baseline levels (Fig. 2), 20% and 23% of the “at risk” group, and 10% and 11% of the “naive” subgroup (similar to the noncardiac general
Depression
Previous studies have been performed examining the prevalence of preoperative depression in the patient undergoing cardiac surgery.6, 7, 18, 19 There has been, however, ambiguity as to whether depression increases or decreases postoperatively.6, 20, 21 A unique feature of this study was the preoperative classification of patients into depression subgroups in conjunction with a serial assessment of depression and physical activity to 6 months postoperatively, thus providing insight into the
Conclusions
Depression in the patient undergoing cardiac surgery appears complex. We have identified that although 7 independent factors are associated with depression before and after cardiac surgery, different mood responses in different subsets of patients exist. Furthermore, patients “at risk” for depression represent a new high-risk subset. Preoperative physical inactivity independently poses a 2-fold risk for depression before surgery and is associated with the development of new depression
Disclosures
The authors have no conflicts to disclose.
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2017, Experimental GerontologyCitation Excerpt :There remains considerable debate as to whether depression in itself is a vascular phenomenon related to the atherosclerosis in these patients (Alexopoulos et al., 1997). The clinical take away highlights the importance of screening for depression in both pre- and post-operatively setting (Horne et al., 2013a, 2013b). Mr. P has lived in the same town for over 60 years and was once very connected in civic and religious organizations.
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These authors contributed equally to this work.