A prospective investigation of depression and adverse outcomes in patients undergoing vascular surgical interventions: A retrospective cohort study using a large mental health database in South London

TY - JOUR

T1 - A prospective investigation of depression and adverse outcomes in patients undergoing vascular surgical interventions: A retrospective cohort study using a large mental health database in South London

AU - Kuruppu, Sajini

AU - Ghani, Marvey

AU - Pritchard, Megan

AU - Harris, Matthew

AU - Weerakkody, Ruwan

AU - Stewart, Robert

AU - Perera, Gayan

PY - 2021/1/18

Y1 - 2021/1/18

N2 - Background: Patients with depression are more susceptible to cardiovascular illness including vascular surgeries. However, health outcomes after vascular surgery among patients with depression is unknown. This study aimed to investigate associations of depression with post-operative health outcomes for vascular surgical patients. Method: A retrospective observational study was conducted using data from a large mental healthcare provider and linked national hospitalisation data for the same south London geographic catchment. OPCS-4 codes were used to identify vascular procedures. Health outcomes were compared between those with/without depression including length of hospital stay (LOS), inpatient mortality and 30-day emergency hospital readmissions. Predictors of these health outcomes were also assessed. Results: Vascular surgery was received by 9,267 patients, including 446 diagnosed with depression. Patients with depression had a higher risk of emergency admission for vascular surgery (OR 1.28; 1.03, 1.59), longer index LOS (IRR 1.38; 1.33-1.42) and a higher risk of 30-day emergency readmission (OR 1.82; 1.35-2.47). Patients with depression had higher inpatient mortality after adjustment for sociodemographic status (1.51; 1.03, 2.23) but not on full adjustment, and had longer emergency readmission LOS (1.13; 1.04, 1.22) after adjustment for sociodemographic factors and CVD. Correlates of vascular surgery hospitalisation among patients with depression included admission through emergency route for longer length of stay, inpatient mortality and 30-day hospital readmission. Conclusion: Patients with depression undergoing vascular surgery have substantially poorer health outcomes. Screening for depression prior to surgery might be indicated to target preventative measures.

AB - Background: Patients with depression are more susceptible to cardiovascular illness including vascular surgeries. However, health outcomes after vascular surgery among patients with depression is unknown. This study aimed to investigate associations of depression with post-operative health outcomes for vascular surgical patients. Method: A retrospective observational study was conducted using data from a large mental healthcare provider and linked national hospitalisation data for the same south London geographic catchment. OPCS-4 codes were used to identify vascular procedures. Health outcomes were compared between those with/without depression including length of hospital stay (LOS), inpatient mortality and 30-day emergency hospital readmissions. Predictors of these health outcomes were also assessed. Results: Vascular surgery was received by 9,267 patients, including 446 diagnosed with depression. Patients with depression had a higher risk of emergency admission for vascular surgery (OR 1.28; 1.03, 1.59), longer index LOS (IRR 1.38; 1.33-1.42) and a higher risk of 30-day emergency readmission (OR 1.82; 1.35-2.47). Patients with depression had higher inpatient mortality after adjustment for sociodemographic status (1.51; 1.03, 2.23) but not on full adjustment, and had longer emergency readmission LOS (1.13; 1.04, 1.22) after adjustment for sociodemographic factors and CVD. Correlates of vascular surgery hospitalisation among patients with depression included admission through emergency route for longer length of stay, inpatient mortality and 30-day hospital readmission. Conclusion: Patients with depression undergoing vascular surgery have substantially poorer health outcomes. Screening for depression prior to surgery might be indicated to target preventative measures.

KW - Depression

KW - Cardiovascular

KW - Surgery

KW - Admission

KW - Mortality

U2 - 10.1192/j.eurpsy.2021.2

DO - 10.1192/j.eurpsy.2021.2

M3 - Article

SN - 0924-9338

JO - European psychiatry : the journal of the Association of European Psychiatrists

JF - European psychiatry : the journal of the Association of European Psychiatrists

ER -