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The Journal of Cardiovascular Surgery 2021 Feb 22

DOI: 10.23736/S0021-9509.21.11553-8


language: English

Symptoms of posttraumatic stress disorder and associated risk factors in type A aortic dissection

Yanjuan LIN 1 , Yiping CHEN 2, Yanchun PENG 3, Shurong XU 2, Sailan LI 3, Xizhen HUANG 3, Liangwan CHEN 3

1 Department of Nursing, Union Hospital, Fujian Medical University, Fuzhou, Fujian; 2 Department of Nursing, Fujian Medical University, Fuzhou, China; 3 Department of Cardiac Surgery, Union Hospital, Fujian Medical University, Fuzhou, Fujian, China


BACKGROUND: Surgery is the primary option of acute type A aortic dissection (AAAD) treatment. However, the unique traumatic stress of cardiovascular disease and surgery brings physical and psychological suffering to the patients and causes posttraumatic stress disorder (PTSD).
HYPOTHESIS: The objective of this study was to investigate the rate of PTSD in AAAD patients after surgery and identify the risk factors of this complication.
METHODS: A prospective cohort design was used. All patients who underwent AAAD surgery from September 2017 to June 2019 were included. Resilience, anxiety, and depression level were assessed before patients discharged from the hospital. Additionally, the PTSD symptoms were assessed three months after discharge from hospital. The data were analyzed by SPSS24.0, P < 0.05 was considered as statistically significant.
RESULTS: 224 patients were included in this study. The incidence of PTSD was 21.4%. Symptoms were highly prevalent with reexperience and increased alertness. “Primary or below” AAAD patients had a significantly higher score in “increased alertness” (P<0.05). Depressive symptoms (B=1.621, β=0.398, P<0.001), female gender (B=-7.539, β=-0.311, P<0.001) were the risk factors associated with PTSD while optimism (B=-0.920, β=-0.169, P=0.012) was the protective factor in AAAD patients.
CONCLUSIONS: AAAD patients exhibited high prevalence of PTSD, which was highly prevalent with reexperience and increased alertness. Higher depressive level, female gender, and lower optimism were associated with higher risk of PTSD. The findings suggest that medical staff should assess the psychological health status of AAAD patients timely and identify high-risk patients early to improve the outcome.

KEY WORDS: Acute type A aortic dissection; Posttraumatic stress disorder; Risk factors

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