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Research Article

Depression, anxiety disorders and Type D personality as risk factors for delirium after cardiac surgery

(Research Assistant) , (Director Cardiac Surgery Research and Perfusion) , (Senior Lecturer) & (Senior Lecturer)
Pages 1005-1011 | Received 18 Mar 2010, Accepted 10 May 2010, Published online: 29 Oct 2010
 

Abstract

Objectives: To determine the prognostic risk of incident delirium after cardiac surgery attributable to preoperative affective disorders and Type D personality.

Methods: Patients awaiting elective coronary revascularization surgery (N = 158; 20.9% female; 11.4% concomitant valve surgery; age M = 64.7, SD = 10.6) underwent the structured MINI International Neuropsychiatric Interview and completed a measure of Type D personality. Postoperative incident delirium was established prior to discharge from the index hospitalization with structured psychiatric interview.

Results: The prevalence of psychiatric disorders before cardiac surgery was 17.1% for major depression, 7.6% for panic disorder, 10.1% for generalized anxiety disorder, and 13.3% for Type D personality, while there were 49 (31% of total) cases of delirium after surgery. After adjustment for sex, older age, cross-clamp time, haemoglobin (Hb) and psychotropic drug use, major depression was significantly associated with delirium, odds ratio (OR) = 3.86 (95% confidence interval (CI) 1.42 to 10.52, p = 0.001). Adjustment for clinical covariates suggested that Type D personality was not significantly associated with delirium, OR = 2.85 (95%CI 0.97 to 8.38, p = 0.06).

Conclusions: Major depression was significantly associated with incident delirium after cardiac surgery. These findings suggest that the risk of incident delirium attributable to major depression was not merely a reflection of common diagnostic features in prospectively examined cardiac surgery patients.

Acknowledgements

The authors would like to thank Dr. Sigrid Tuble for her assistance with recruiting patients.

Declaration of interest: This research was supported by an Australian Postgraduate Award and the Sir Robert Menzies Memorial Research Scholarship in the Allied Health Sciences for P.J. Tully.

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