Prevalence and Impact of Depression in a Sample of Patients Treated in a Digestive Surgery Department

摘要

Depression in hospitalized patients is a specific nosological entity that has been widely described. It would be responsible in other disciplines such as cardiac surgery of an increase in postoperative mortality, but a few data are available in digestive surgery. The purpose of this study was to determine the prevalence of hospital depression and its impact on postoperative outcomes in a sample of patients, treated in digestive surgery department for benign and malignant illnesses, for a period of two months. Between November 2016 and January 2017, data from 117 hospitalized patients were collected prospectively. All patients with suspected depression at the first psychological interview underwent a Beck Depression Inventory. Patients were recognized as depressed when the Beck score was equal or superior to 13. The preoperative and postoperative data of patients identified as "depressed" were compared to the "non-depressed" population. The prevalence of depression in the general population was 17.9. Twenty-one "depressed" operated patients were compared to 58 "non-depressed" operated patients. There was no difference between the two groups in terms of preoperative serum albumin (p = 1), preoperative weight (p = 0.35), prevalence of cancer (p = 1), curative/palliative intent management (p = 0.66), and patients facing emergency procedures (p = 0.17). There were also no significant differences in terms of postoperative morbidity (Clavien II and III respectively p = 0.18 and p = 0.44) but there was nevertheless more anxiety (p = 0.0013), more postoperative parietal sepsis (p = 0.00083) and a longer postoperative stay (p = 0.00037) in the depressed group. In multivariate analysis, only anxiety (OR = 9.31; CI: 2.19-55.73; p = 0.0056) and postoperative parietal sepsis (OR = 7.5; CI: 1.9-39.2; p = 0.007) were correlated with depression. The presence of depression in a surgical setting is a common event. It could be responsible of an increase in postoperative morbidity. Studying larger populations with specific subgroups would make possible to refine screening and discuss a management of patients upstream surgical act.