Timing of depressive symptom onset and in-hospital complications among acute coronary syndrome inpatients.

摘要

BACKGROUND: Recent research has reported an association between in-hospital depression and poorer long-term prognosis and a greater risk of in-hospital complications. OBJECTIVE: The purpose of the current study was to examine the relationship between past and incident depressive symptoms and in-hospital complications in acute coronary syndrome (ACS) inpatients. METHOD: A group of 906 ACS inpatients from 12 coronary-care units participated in the study. Incident depressive symptoms were assessed through the Beck Depression Inventory, and participants' were asked about past history of prolonged depressed mood. In-hospital complications were noted as present or absent by nurses, and authors conducted logistic-regression analyses. RESULTS: A subset of 492 patients (58.4%) experienced an in-hospital complication, the most common being ischemia (48.8%) and cardiac arrest (7.2%). After adjusting for prognostic indicators, incident and past-combined-with-incident depressive symptoms were significantly associated with an increased risk of experiencing an in-hospital complication. CONCLUSION: Incident symptoms, in particular, seem to be prognostic. This finding suggests that acute emotions may be triggering cardiac complications, and early identification of emotional symptoms is warranted.