Abstract
Background:
Studies have shown that depression is a prevalent condition among cardiac patients, especially after cardiac surgery, and that it's presance has been related to negative outcomes. The purpose of this study was to perform a meta-analysis to evaluate depression as a risk factor for all-cause mortality in patients status post cardiac surgery.
Methods:
A search of MEDLINE (1966 - October 2009) database was performed and we selected all prospective cohort studies in which depression was measured pre-operatively, postoperatively, or both by an established depression index with all-cause mortality recorded after a minimum follow up of 1 year. The pooled relative risk (RR) with corresponding 95% confidence interval (CI) was calculated for all cause mortality using the fixed effects method to evaluate the effects of depression on all-cause mortality in post cardiac surgery patients.
Results:
Our search strategy yielded 144 studies, of which only 6 met our inclusion criteria. The studies comprised of 1,906 patients, predominately white, males who have undergone coronary artery bypass grafting (64% or 1228 of 1906) or cardiac valve replacement (36% or 678 of 1906) and where evaluated for depression. The RR of all-cause mortality was 1.8; 95% CI (1.4-2.5) for patients with significant depression compared to patients without.
Conclusion:
Depression is associated with higher all-cause mortality in patients status-post cardiac surgery. All patients should be evaluated for depression after cardiac surgery and treated aggressively.