Depression and Geographic Status as Predictors for Coronary Artery Bypass Surgery Outcomes |
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Authors: | Tam K. Dao,PhD, Danny Chu,MD, Justin Springer,PhD, Emily Hiatt,BA, & Quang Nguyen,PhD |
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Affiliation: | Department of Educational Psychology, University of Houston, Houston, Texas;Michael E. DeBakey Veterans Affairs Medical Center, Department of Surgery, Houston, Texas;Baylor College of Medicine, and the Department of Psychiatry and Behavioral Sciences, Houston, Texas;Baylor College of Medicine, and the Division of Cardiothoracic Surgery, Houston, Texas |
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Abstract: | Purpose: To examine the relationships between depression, geographic status, and clinical outcomes following a coronary artery bypass grafting (CABG) surgery. Methods: Using the 2004 Nationwide Inpatient Sample database, we identified 63,061 discharge records of patients who underwent a primary CABG surgery (urban 57,247 and rural 5,814). We analyzed 7 demographic variables, 19 preoperative medical and psychiatric variables, and 2 outcome variables (ie, in-hospital mortality and length of stay). Logistic regression and multivariable regression analyses were used to assess urban-rural status and depression as independent predictors of in-hospital mortality and length of stay. Findings: Rural patients were more likely to have a comorbid depression diagnosis compared to urban patients (urban = 19.4%, rural = 21.4%, P < .001). After adjusting for confounding factors, having a comorbid depression diagnosis ( B = 1.10, P < .001) and residing in a rural area ( B = .986, P < .05) were associated with an increased length of in-hospital stay following CABG surgery. Furthermore, having a depression diagnosis (OR = 1.63, 95% CI = 1.45-2.21) and residing in a rural area (OR = 1.43, 95% CI = .896-1.45) were associated with an increased likelihood of in-hospital mortality. Conclusions: Rural patients were more likely than urban ones to have a depression diagnosis. Depression was a significant independent predictor of both in-hospital mortality and length of stay for patients receiving CABG surgery. Also, rural patients had increased lengths of in-hospital stay as well as in-hospital mortality rates compared to those who resided in urban areas. |
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Keywords: | CABG cardiovascular disease mental health rural urban |
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