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Introduction: Cardiovascular surgery can trigger depression; counselling and medications can easily beat it. The earlier we identify people who have depression, complicating their ability to get back to normal life, better is the chances of recovery. We conducted a prospective randomized observational study to assess incidence of depression in patients undergoing cardiac surgery and risk factors which can trigger depression. Materials and Methods: A prospective randomized double blind controlled Observational clinical study was conducted in 250 patients who underwent open heart surgery with and without assistance of cardio pulmonary bypass (CPB) from May 2013 to July 2014. All patients were screened for depression with Patient Health Questionnaire (PHQ-9) preoperatively (Q1), at hospital discharge (Q2), 3months (Q3) and 6months (Q4) postoperatively. At each interval patients were identified as ‘‘not depressed’’ (PHQ-9 score 0), minimally depressed (score 1-4), mild(score5-9), moderate (10-14), moderately severe(15-19), severe depression(20-27). Multiple regression analysis was used to identify variables associated with depression. Results: On regression analysis, preoperative depression for depression at discharge (OR 88.5, p<0.0001), depression at discharge for incidence of depression at three months (OR 4004, p<0.0001) and 6 months (OR 1194, p<0.0001) had significant Odds ratio (OR) with statistical significance. Patients who had depression at discharge were older, had lower preoperative ejection fraction (EF), prolonged waiting period, ICU stay, hospital stay. Other risk factors identified were higher NYHA class , history of prior CCF, abnormal lipid profile, pre-existing hypertension, diabetes mellitus, peripheral vascular disease and patients on beta blockers. Conclusion: Depression is common after cardiac surgery. Among all the risk factors, preoperative depression was associated with the highest risk for postoperative depression.

Keywords: Depression, PHQ-9 Questionnare, Cardiac surgery.





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