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Influence of Depression On Recovery After Major Surgical Operations. Do Surgeons Take This Data into Account? a Prospective Cohort Study.

Published online by Cambridge University Press:  15 April 2020

M. Orri ,
C. Barry ,
C. Hassler ,
E. Boleslawski ,
J.M. Reimbeau ,
Y.P. Le Treut ,
P. Bachellier ,
O. Scatton ,
J.Y. Mabrut  and
M. Adham
...Show all authors
M. Orri
Affiliation:
U669, INSERM, Paris, France
C. Barry
Affiliation:
U669, INSERM, Paris, France
C. Hassler
Affiliation:
U669, INSERM, Paris, France
E. Boleslawski
Affiliation:
Service chirurgie HPB, Hôpital Claude Huriez, Lille, France
J.M. Reimbeau
Affiliation:
Service chirurgie HPB, Hopital Nord, Amiens, France
Y.P. Le Treut
Affiliation:
Service chirurgie HPB, Hopital Conception, Marseille, France
P. Bachellier
Affiliation:
Service chirurgie HPB, Hopitaux Universitaires, Strasbourg, France
O. Scatton
Affiliation:
Service chirurgie HPB, Hopital Saint Antoine, Paris, France
J.Y. Mabrut
Affiliation:
Service chirurgie HPB, Hopital de la Croix Rouge, Lyon, France
M. Adham
Affiliation:
Service chirurgie HPB, Hopital Edual Heriot, Lyon, France
E. Vibert
Affiliation:
Service chirurgie HPB, Hopital Paul Brousse, Paris, France
A. Revah-Levy
Affiliation:
Centre de soins psychotherapeutiques de transition pour adolescent, Centre Hospitalier d'Argenteuil, Argenteuil, France
O. Farges
Affiliation:
Service chirurgie HPB, Hopital Beaujon, Clichy, France

Abstract

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Introduction

Depression is one of the main causes of disability in the Western countries. This evidence presents new challenges for somatic medicine, such as surgery.

Objectives

To determine the influence of patients’ depression on (i) length of hospital stay (LOS, which is a proxy of recovery) after major surgery, and (ii) LOS anticipated by surgeon preoperatively.

Aims

To explore the influence of depression on recovery after major surgery, and whether and how surgeons take into account patients’ emotional and psychological status in the care of their patients.

Methods

Prospective multicentre observational study. Depression was assessed with HADS (HADS > 8 showing the presence of significant depression). Two cox PH models were fitted to evaluate the influence of depression on patients’ LOS (first model) and anticipated LOS (second model). Adjustment variables were (i) preoperative (age, sex, anxiety, diagnosis, BMI, biology), (ii) intraoperative (blood transfusion, length of intervention), (iii) postoperative (morbidity).

Results

Of 372 recruited patients (which had undergone major liver surgery), 69 (18,5%) had HADS>8. After adjustment, depression was a risk factor for a prolonged LOS (HR 1.96, 95%CI 1.44–2.63). However, depression was unrelated to the anticipated LOS (HR 1.26, 95%CI 0.90–1.66).

Conclusions

1 in 5 patients presented a significant level of depression. Depression was independently associated to longer LOS (ie. longer recovery time after surgery). However this data was not taken into account by surgeons, which failed to integrate that in their previsions. A psychiatric culture and education need to be developed in surgery, as well as more collaboration.

Type
Article: 0709
Information
European Psychiatry , Volume 30 , Issue S1: Abstracts of the 23rd European Congress of Psychiatry , March 2015 , pp. 1
Copyright
Copyright © European Psychiatric Association 2015
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