Oct 27, 2010 08:36 AM
Initial analysis shows that the death rates within 30 days after surgery are similar for patients with and without psychiatric illness – 3.8 percent and 4 percent, respectively. But when the researchers looked for other factors, the death rate was higher for patients with a psychiatric condition. People with depression and anxiety have a slightly higher risk of death after undergoing surgery.
Further analysis showed that the high risk of death was associated with depression and anxiety, but not any other psychiatric condition. Also, death rates were higher among patients with psychiatric conditions who had respiratory or digestive system surgery, but not for those who had surgery involving the circulatory, nervous or musculoskeletal systems.
According to the researchers several potential mechanisms exist to explain these findings. First, studies indicate that patients with depression frequently do not adhere to medical recommendations for underlying medical conditions. It is therefore plausible that such under-treated conditions may affect postoperative care and outcome. Second, patients with existing psychiatric complications may be more likely to undergo surgery by a lower-quality surgeon or hospital. Third, pre-existing psychiatric complications may serve as an indicator for greater severity of surgical risk.
Therefore, the findings suggest that surgical patients with depression or anxiety require special care. The researchers recommended that surgeons caring for patients with a history of anxiety or depression seek early involvement of multidisciplinary teams to help identify problematic areas in perioperative care processes, particularly regarding issues of surgeon-patient communication and adherence to post-surgical recommendations.
