Post-op mortality up for elderly with pre-heart op anxiety

Few elderly patients about to undergo cardiac surgery experience high levels of anxiety, but for those who do, there is a five-fold higher risk of postoperative major morbidity or mortality, according to research published in the Jan. 1 issue of The American Journal of Cardiology.

14 Jan 2013—Few elderly patients about to undergo cardiac surgery experience high levels of anxiety, but for those who do, there is a five-fold higher risk of postoperative major morbidity or mortality, according to research published in the Jan. 1 issue of The American Journal of Cardiology.

To examine the correlation between patient-reported anxiety and post-cardiac surgery mortality and major morbidity, Judson B. Williams, M.D., M.H.S., of the Duke University Medical Center in Durham, N.C., and colleagues conducted a prospective, multicenter cohort study—Frailty Assessment Before Cardiac Surgery—involving 148 elderly patients (mean age, 75.8 years) who were undergoing coronary artery bypass surgery and/or valve repair or replacement.

The researchers found that 7 percent of patients reported high levels of preoperative anxiety, with no difference based on type of surgery or Society of Thoracic Surgeons predicted risk. Preoperative anxiety independently predicted postoperative mortality or major morbidity, after adjustment for potential confounding variables (odds ratio, 5.1).

"Significant levels of patient-reported preoperative anxiety independently predicted a greater risk of in-hospital mortality or major morbidity in elderly patients undergoing cardiac surgery," the authors write. "Importantly, because high levels of anxiety are potentially modifiable, identifying these patients could provide an opportunity to increase psychological comfort and improve the clinical outcomes in this high-risk group."

More information: Abstract 
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