Utjecaj depresivnosti na operacijski rizik u bolesnika koji se podvrgavaju kardiokirurškoj revaskularizaciji miokarda

doctoral thesis

• Title (english): Influence of depression on operative risk in patients undergoing coronary artery bypass graft surgery
• Author: Stjepan Ivanković
• Mentor: Vedran Ćorić (mentor)
• Mentor: Alma Mihaljević-Peleš (komentor)
• Committee member: Bojan Biočina (predsjednik povjerenstva)
• Committee member: Rudolf Gregurek (član povjerenstva)
• Committee member: Darko Marčinko (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; Zagreb
• Defense date and country: 2022-12-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Surgery
• Universal decimal classification (UDC): 616 - Pathology. Clinical medicine

Abstract

Ovo istraživanje imalo je za cilj povezati preoperativnu izraženost depresivnih simptoma kod CABG bolesnika s rezultatima Euroscore II, CRP-a i stopom oporavka bolesnika (izraženom kroz duljinu postoperativnog boravka u bolnici (PDB), danima provedenim u jedinici intenzivnog liječenja (JIL), vremenom ekstubacije (ET)).
U uzorku od 212 elektivnih CABG bolesnika, podijeljenih u dvije skupine PRIME-MD i BDI-II. Pre/postoperativne vrijednosti CRP-a mjerene su kod bolesnika prije operacije i tijekom boravka u bolnici. Dobivene su tri vrijednosti CRP-a: 1-3 dana, „rani“, 4-6 dana, „kontinuirani“ i 1-6 dana, „sveukupni“ postoperativni CRP. Operacijski rizik procijenjen je pomoću EuroSCORE II, koji je bio viši (P< 0.001) u bolesnika s povišenim depresivnim simptomima. PDB (>7 dana) je bio značajno povezan s višim postoperativnim vrijednostima CRP-a izmjerenim 3.(P<0.009), 4. (P< 0.001), 5. (P<0.001), i 6. (P<0.001) postoperativni dan i s „kontinuiranim“ (P< 0.001), i „sveukupnim“ (P< 0.001), rezultatom promjene CRP-a.
Prijeoperativni CRP i „rani“ rezultat promjene CRP-a nisu bili povezani s trajanjem PDB-a. Skupina bolesnika s duljim PDB-om i skupina bolesnika s povišenim depresivnim simptomima u preoperativnim nalazima imale su nižu ejekcijsku frakciju i statistički (P = 0.001) značajnu anemiju.
Naši rezultati pokazuju da su viši depresivni simptomi povezani s duljim PDB-om i ET-om, ali nema utjecaja na dužinu boravka u JIL-u. Depresivniji bolesnici pokazali su više preoperativne vrijednosti CRP-a (P = 0,007) i veće vrijednosti CRP-a prvog dana nakon operacije (P = 0,046). Stariji pacijenti s više simptoma i kroničnih bolesti te žene su skloniji razvoju depresivnih simptoma.

Abstract (english)

This study aimed to identify the association of preoperative depression in CABG patients with Euroscore II, C-reactive protein values and patient recovery rate (expressed through the length of postoperative hospital stay (LOS), days spent in the intensive care unit (ICU), extubation time (ET)).
In a sample of 212 elective CABG patients, divided into two groups PRIME-MD and BDI-II. Pre and postoperative CRP values were measured in patients before surgery and during hospital stay. EuroSCORE II, was higher (P <0.001) in patients with elevated depressive symptoms. LOS (> 7 days) was significantly associated with higher postoperative CRP values. Preoperative CRP and the “early” result of CRP change were not related to the duration of LOS. The group of patients with longer LOS and the group of patients with elevated depressive symptoms in preoperative findings had a lower ejection fraction and statistically (P = 0.001) significant anemia.
Depressed patients showed higher preoperative CRP values (P = 0.007) and higher CRP values on the first day after surgery (P = 0.046). Elderly patients with more symptoms and chronic diseases and these women are more prone to develop depressive symptoms.

• Keywords: depresivni simptomi; depresivnost; Euroscore II; CABG; CRP
• Keywords (english): Depression; depressive symptoms; Euroscore II; CABG; CRP
• Language: croatian
• URN:NBN: urn:nbn:hr:105:655663
• Study programme: Title: Biomedicine and Health Sciences; Study programme type: university; Study level: postgraduate; Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstvo (doktor/doktorica znanosti, područje biomedicine i zdravstvo)
• Type of resource: Text
• Extent: 92 str.
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-01-12 09:25:37