The relationships between depression, body mass index, quality of sleep and post-operative atrial fibrillation, and length of stay of patient undergoing open heart surgery

Authors

  • Aroontree Kaurkeaw The Student of Master thesis, Master of Nursing Science (Adult Nursing), Faculty of Nursing, Mahidol University
  • Suporn Danaidutsadeekul Faculty of Nursing, Mahidol University
  • Kessiri Wongkongkam Faculty of Nursing, Mahidol University
  • Kriangkrai Tantiwongkosri Department of Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University

Keywords:

depression, body mass index, quality of sleep, atrial fibrillation, length of stay

Abstract

This study aimed to study the relationship between depression, body mass index, quality of sleep, post-operative atrial fibrillation (POAF), and the length of hospital stay after surgery in open heart surgery patients at 2 tertiary hospitals in Bangkok. The sample consisted of 82 patients who underwent open heart surgery. The research instruments include the Thai Depression Inventory, the Verran and Snyder-Halpern Sleep Scale (VSH), and the Sleep Scale. A personal data collection form, The Confusion Assessment Method of the ICU (CAM-ICU), and post-operative atrial fibrillation and length of stay collation form were used to collect data. Descriptive statistics were used to analyze the data, and the relationship between the variables studied was examined using Spearman's correlation coefficient. 

The results showed the mean age of the sample was 59.22 years old, 57.3% were male, 48% of them had moderate ejection fraction (Ejection Fraction: EF 50.01-80.00%), depression average score was 10.96, the average body mass index was 31.7%, obesity level 1, and 34.1% had a good quality of sleep. 37.8% had POAF and the length of hospital stay after open heart surgery was 7.84 days. The research results found that depression before surgery and POAF were significantly correlated with the length of hospital stay after open heart surgery (r = 0.247, r = 0.508; p < 0.05, respectively). Body mass index before surgery and quality of sleep after surgery were not statistically significantly associated with the length of hospital stay after open heart surgery. (r = 0.138, r = -0.172; p > 0.05, respectively)

 A recommendation from this research is to encourage screening for depression before surgery and perform treatment before open heart surgery.

References

Wallace A. Chapter 25 - Cardiovascular disease. in: Manuel C. Pardo, Jr., Ronald D. Miller, editors. Basics of anesthesia. 6th ed. Philadelphia, Elsevier; 2018.p. 415-46.

MoPH-TUC Co-Unit. Public Health Statistics A.D.2017. [document on the internet]. 2017. [Cited 2017 Apr 24]. Available from: http://bps.moph.go.th/new_bps/sites/default/ files/health _strategy.pdf

Epidemiology division Department of disease control Ministry of Public Health. Coronary Artery Disease (CAD) 2019. [document on the internet]. 2017. [Cited 2017 Apr 24]. Available from: https://ddc.moph.go.th/ uploads/files/ 1081120191227084415.pdf

Matei VA. Cardiopulmonary Bypass (CPB). [document on the internet]. 2011. [Cited 2017 Apr 24]. Available from: https://www.clinicalkey .com/#!/content/book/3-s2.0-B97814377 17204 003691 ?scrollTo=% 23hl0000059

Huffmyer JL, Groves DS. Pulmonary complications of cardiopulmonary bypass. Best Pract Res Clin Anaesthesiol. 2015;29(2):163-75.

Grocott MP, Pearse RM. Prognostic studies of perioperative risk: robust methodology is needed. Br J Anaesth. 2010;105(3):243-5.

Hengcharoensuwan P. Utriyaprasit K. Sindhu S. Laksanabunsong P. Factors Associated with Postoperative Length of Hospital Stay in Coronary Artery Bypass Graft Patients. Journal of Nursing Science. 2010;28(1): 58-66. (in Thai).

Borowicz L, Grega M, Lyketsos C. Depression and cardiac morbidity 5 years after coronary artery bypass surgery. Psychosomatics. 2002; 43(6): 464-71.

Rymaszewska J, Kiejna A, Hadryś T. Depression and anxiety in coronary artery bypass grafting patients. Eur. Psychiatry. 2003;18(4):155-60.

Ghoneim MM, O’Hara MW. Depression and postoperative complications: an overview. BMC Surg. 2016;16(5).

Bufalino C, Hepgul N, Aguglia E, Pariante CM. The role of immune genes in the association between depression and inflammation: a review of recent clinical studies. Brain Behav Immun. 2013;31:31-47.

Patel D, Mc Conkey ND, Sohaney R, Mc Neil A, Jedrzejczyk A, Armaganijan L. A systematic review of depression and anxiety in patients with atrial fibrillation: the mind-heart link. Cardiovasc. Psychiatry Neurol. 2013;2013: 159850. doi: 10.1155/2013/ 159850. Epub 2013 Apr 27. PMID: 23710335; PMCID: PMC3655604.

Mathijssen N, Verburg H, Leeuwen C, Molenaar T, Hannink G, Mathijssen NMC, et al. Factors influencing length of hospital stay after primary total knee arthroplasty in a fast-track setting. Knee Surg Sports Traumatol Arthrosc. 2016 Aug;24(8):2692-6. doi: 10.1007/s00167-015-3932-x. Epub 2015 Dec 19. PMID: 26685683

Barnett SD, Martin LM, Halpin LS, Ad N. Impact of body mass index on clinical outcome and health-related quality of life following open heart surgery. J. Nurs. Care Qual. 2010;25(1):65-72.

Rakim W, Taboonpong S, Chailungka P, Juthong S. Sleep quality, factors interfering with sleep and intervention activities among patients receiving mechanical ventilation. Songklanagarind Medical Journal. 2006;24(4):289-98. (in Thai).

Kijjanon N, Get-Kong S. Factors Influencing Length of Stay in Open Heart Surgery Patients. Thai Journal of Cardio-Thoracic Nursing. 2009;20(1):33-45. (in Thai).

Kijjanon N., Deebanklong S. A Comparison of Length of Hospital Stay and Complications in Patients with On-Pump and Off-Pump Coronary Artery Bypass Surgery. Ramathibodi Nursing Journal. 2011;17(3). 358-70. (in Thai).

Guenancia C, Binquet C, Laurent G, Vinault S, Bruyere R, Prin S, et al. Incidence and predictors of new-onset atrial fibrillation in septic shock patients in a medical ICU: data from 7-day Holter ECG monitoring. PLoS One. 2015;10(5): e0127168. doi: 10.1371/journal. pone.0127168. PMID: 25965915; PMCID: PMC4428753.

Almashrafi A, Elmontsri M, Aylin P. Systematic review of factors influencing length of stay in ICU after adult cardiac surgery. BMC Health Serv. Res. 2016;16:1-12.

Todorov H, Janssen I, Honndorf S, Bause D, Gottschalk A, Baasner S, et al. Clinical significance and risk factors for new onset and recurring atrial fibrillation following cardiac surgery - a retrospective data analysis. BMC Anesthesiol. 2017;17:1-10.

Hart SA, Tanel RE, Kipps AK, Hoerst AK, Graupe MA, Cassidy SC, et al. Intensive Care Unit and Acute Care Unit Length of Stay After Congenital Heart Surgery. Ann Thorac Surg. 2020 Oct;110(4):1396-1403. doi: 10.1016/j. athoracsur.2020.01.033. Epub 2020 Feb 28. PMID: 32114048; PMCID: PMC8541825.

Cohen J. Statistical Power Analysis for the Behavioral Sciences. Second Edition ed. United States of America: Lawrence Erlbaum Associates; 1977. p.567.

Trongsakul S, Lambert R, Clark A, Wongpakaran N, Cross J. Development of the Thai version of Mini-Cog, a brief cognitive screening test. Geriatrics and Gerontology International. 2015;15(5):594-600. (in Thai).

Lotrakul M, Sukanich P. Development of the Thai Depression Inventory. J Med Assoc Thai. 1999 Dec;82(12):1200-7. PMID: 10659561.

Pipanmekaporn T, Wongpakaran N, Mueankwan S, Dendumrongkul P, Chittawatanarat K, Khongpheng N, et al. Validity and reliability of the Thai version of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Clin Interv Aging. 2014 May 29;9:879-85. doi: 10.2147/CIA.S62660. PMID: 24904208; PMCID: PMC4043427.

Yodchai K. Selected factors related to quality of sleep in hospitalized cardiac disease patients. [Thesis of Master of Nursing Science]. Bangkok: Chulalongkorn University; 2004. (in Thai).

Clyde W. Yancy, Mariell Jessup, Biykem Bozkurt, Javed Butler, Donald E. Casey, Mark H. Drazner, et al. American College of Cardiology Foundation/ American Heart Association Task Force on Practice Guidelines. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation. 2013 Oct 15;128(16):e240-327. doi: 10. 1161/CIR.0b013e31829e8776. Epub 2013 Jun 5. PMID: 23741058.2013 ACCF/AHA

Lichtman Jh Fau - Bigger JT, Jr., Bigger Jt Jr Fau - Blumenthal JA, Blumenthal Ja Fau - Frasure-Smith N, Frasure-Smith N Fau - Kaufmann PG, Kaufmann Pg Fau - Lesperance F, Lesperance F Fau - Mark DB, et al. Depression, and coronary heart disease: recommendations for screening, referral, and treatment: a science advisory from the American Heart Association Prevention Committee of the Council on Cardiovascular Nursing, [journal on the internet]. 2008. [Cited 2017 Nov 13]. Available from: http://circ.ahajournals.org

Connerney I, Shapiro PA, McLaughlin JS, Bagiella E, Sloan RP. Relation between depression after coronary artery bypass surgery and 12-month outcome: a prospective study. The Lancet. 2001;358(9295):1766-71.

Poole L, Leigh E, Kidd T, Ronaldson A, Jahangiri M, Steptoe A. The combined association of depression and socioeconomic status with length of post-operative hospital stay following coronary artery bypass graft surgery: data from a prospective cohort study. J. Psychosom. Res. 2014;76(1):34-40.

Lomivorotov VV, Efremov SM, Pokushalov EA, Karaskov AM. New-Onset Atrial Fibrillation After Cardiac Surgery: Pathophysiology, Prophylaxis, and Treatment. J Cardiothorac Vasc Anesth. 2016;30(1):200-16.

Mariscalco G, Biancari F, Zanobini M, Cottini M, Piffaretti G, Saccocci M, et al. Bedside tool for predicting the risk of postoperative atrial fibrillation after cardiac surgery: the POAF score. J Am Heart Assoc. 2014;3(2):e000752.

Siriratwarangkul S. Complications after Open Heart Surgery at Suratthani Hospital. Thai Journal of Anesthesiology. 2020;1(46):7-14. (in Thai).

Thongma P. Thosinghan O. Sindhu S. Slisatkorn W. Predicting factors on atrial fibrillation among patients undergoing open heart surgery. Thai Journal of Cardio-Thoracic Nursing. 2016;27(2):114-26. (in Thai).

Downloads

Published

2022-09-24

How to Cite

1.
Kaurkeaw A, Danaidutsadeekul S, Wongkongkam K, Tantiwongkosri K. The relationships between depression, body mass index, quality of sleep and post-operative atrial fibrillation, and length of stay of patient undergoing open heart surgery. Thai J Cardio-Thorac Nurs. [Internet]. 2022 Sep. 24 [cited 2024 Jun. 13];33(1):99-116. Available from: https://he02.tci-thaijo.org/index.php/journalthaicvtnurse/article/view/250638

Issue

Section

Research Articles