Depression and Geographic Status as Predictors for Coronary Artery Bypass Surgery Outcomes

Autor/inn/en	Dao, Tam K.; Chu, Danny; Springer, Justin; Hiatt, Emily; Nguyen, Quang
Titel	Depression and Geographic Status as Predictors for Coronary Artery Bypass Surgery Outcomes
Quelle	In: Journal of Rural Health, 26 (2010) 1, S.36-43 (8 Seiten) PDF als Volltext Verfügbarkeit
Sprache	englisch
Dokumenttyp	gedruckt; online; Zeitschriftenaufsatz
ISSN	0890-765X
DOI	10.1111/j.1748-0361.2009.00263.x
Schlagwörter	Hospitals; Outcomes of Treatment; Mortality Rate; Surgery; Identification; Patients; Urban Areas; Rural Areas; Depression (Psychology); Heart Disorders; Geographic Location; Databases; Psychiatry; Multiple Regression Analysis; Clinical Diagnosis; Comparative Analysis + Suchen Sie Ihr Suchwort? Krankengymnast; Krankenhaus; Mortalitätsrate; Chirurgie; Identifikation; Identifizierung; Patient; Urban area; Stadtregion; Rural area; Ländlicher Raum; Herzkrankheit; Datenbank; Psychiatrie
Abstract	Purpose: To examine the relationships between depression, geographic status, and clinical outcomes following a coronary artery bypass grafting (CABG) surgery. Methods: Using the 2004 Nationwide Inpatient Sample database, we identified 63,061 discharge records of patients who underwent a primary CABG surgery (urban 57,247 and rural 5,814). We analyzed 7 demographic variables, 19 preoperative medical and psychiatric variables, and 2 outcome variables (ie, in-hospital mortality and length of stay). Logistic regression and multivariable regression analyses were used to assess urban-rural status and depression as independent predictors of in-hospital mortality and length of stay. Findings: Rural patients were more likely to have a comorbid depression diagnosis compared to urban patients (urban = 19.4%, rural = 21.4%, P less than 0.001). After adjusting for confounding factors, having a comorbid depression diagnosis (B = 1.10, P less than 0.001) and residing in a rural area (B = 0.986, P less than 0.05) were associated with an increased length of in-hospital stay following CABG surgery. Furthermore, having a depression diagnosis (OR = 1.63, 95% CI = 1.45-2.21) and residing in a rural area (OR = 1.43, 95% CI = 0.896-1.45) were associated with an increased likelihood of in-hospital mortality. Conclusions: Rural patients were more likely than urban ones to have a depression diagnosis. Depression was a significant independent predictor of both in-hospital mortality and length of stay for patients receiving CABG surgery. Also, rural patients had increased lengths of in-hospital stay as well as in-hospital mortality rates compared to those who resided in urban areas. (As Provided).
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Erfasst von	ERIC (Education Resources Information Center), Washington, DC
Update	2017/4/10