Table S1. Review of the studies assessing the relation between depression (measured preoperatively) and surgical outcomes
Author,
year
Saur, 20011
Type of
surgery
Cardiac
surgery
Sample
size
analysis
N
Prevalence of
depression (%)
(continuous
variable)
Measure
Cardiac
surgery
Cardiac
surgery
Cardiac and
vascular
surgery
Liver and
kidney
transplant
158
Prospective
N
15.2
817
Prospective
Y
38
CES-D
55,864
Retrospecti
ve
Y
339
Prospective
Y
Cardiac
surgery
Various
310
Retrospective
0.02
(Major
depression)
51.6
(Depression
during the
waiting list
period)
30.3
2624
Prospective
Y
Linnen,
20118
Cardiac
surgery
5429
Prospective
Poole, 20149
101
Menendez,
201410
Cardiac
surgery
Spinal
surgery
Browne,
201411
Wang,
201312
Corruble,
20115
Poole, 20146
Kerper,
20137
Prospective
Multivariate
Medical
Outcomes Study
36-item shortform
DASS
Baker,
20012
Blumental,
20033
Copeland,
20144
416
Design
Outcomes
LOS, readmission
rates, and mortality
Length of
follow-up
6 months
for
Main results
Higher hospital readmission rate 6 months after the
procedure
readmission
Mortality
Higher mortality among depressed
Mortality
4 to 48
months
6 months
Diagnosis code
presents in the
register
BDI
Mortality
1 year
Increased mortality for patients with bipolar disorder, for
cardiac surgery only
Graft survival,
patient survival
18 months
Depression increasedrisk of graft failure and mortality.
BDI
LOS
Discharge
Depression associated with longer LOS
11.3
CES-D
LOS
Discharge
Depression associated with longer LOS
Y
29.7
WHO-5 wellbeing score ≤ 13
LOS
Discharge
Depression associated with longer LOS
Prospective
Y
31
BDI
LOS
Discharge
5382
343
Retrospective
Y
4.5
ICD-9-CM
criteria
Total joint
arthroplasty
497 22
2
Retrospective
Y
10
ICD-9-CM
criteria
1. non-routine
discharge
2. adverse events
3. in-hospital
mortality
In hospital
morbidity, mortality,
LOS, and hospital
charges following
TJA
Depression associated with longer LOS. Mediating role of
CRP
Depression was associated with higher rates of nonroutine discharge and higher rates of adverse events.
Percutaneous
coronary
intervention
400
Prospective
Y
38.5
MINI
Major adverse
cardiovascular event
(MACE) including
mortality, nonfatal
myocardial
3 years
Higher mortality among depressed
Depression was associated with higher risk of several
complications (in-hospital post-operative psychosis,
anemia, pulmonary embolism, and infection), lower risk
of cardiac and gastrointestinal complications, and not
associated with in-hospital mortality. (multivariate)
Depression associated with longer length of stay
(univariate)
Depression is an independent predictor of 3-year MACE,
mortality, and repeat revascularization
Rothenbacher,
infarction, or repeat
revascularization
Fatal and non-fatal
cardiovascular
disease events.
Mortality
Cardiac
surgery
1052
Prospective
Y
5.9
HADS
200713
Cserép,
201214
Cardiac
surgery
180
Prospective
Y
STAI-S/STAI-T
BDI
Oxlad,
200615,16
Cardiac
surgery
119
Prospective
Y
7.7 (depression
only); 35.9 (both
anxiety and
depression)
14.3
Stundner,
201217
Total joint
arthroplasty
1212,493
Retrospective
Y
ICD-9-CM
criteria
Stenman,
201418
Cardiac
surgery
56,064
Retrospective
Y
1.81 (depression
only); 0.07 (both
anxiety and
depression)
0.6
NavarroGarcia,
201119
Dao, 200920
Cardiac
surgery
100
Prospective
?
19
HADS
Cardiac
surgery
Cardiac
surgery
Neurosurgery
?
Retrospective
Y
25.9
63051
Retrospective
Y
19.4
1052
Retrospective
Y
5
Cardiac
surgery
Neurosurgery
89
Prospective
Y
28
ICD-9-CM
criteria
ICD-9-CM
criteria
Diagnosis by a GP
or psychiatrist
BDI
75
Prospective
N
2.5 to 15.4
BDI
Cardiac
surgery
648
Prospective
Y
29.2
Mortality
Cardiac
surgery (heart
transp)
Cardiac
surgery (heart
transp)
108
Prospective
Y
30.8
Standard Mental
health Inventory
screening (?)
Psychiatric
interview
147
Prospective
Y
24.5
BDI
Dao, 201021
Gathinji,
200922
Burg,
200323,24
Mainio,
200525
Ho, 200526
Owen,
200627
Havik,
200728
Pubmed entry:
DASS
ICD-9-CM
criteria
Cardiac-related
hospital admission
LOS
Perioperative
morbidity, mortality,
LOS, discharge, and
cost
Mortality,
combined,
cardiovascular
events (combined
end point of death or
rehospitalization for
myocardial
infarction, heart
failure, or stroke)
LOS, postoperative
morbidity (pain,
analgesic consumpt)
In-hospital mortality
3 years
Depression increased the risk of cardiovascular events.
Median 7.5
years
Depression did not significantly influence mortality.
6 months
Depression increasedcardiac-related hospital admission,
and LOS.
Depression was associated with in-hospital mortality. The
risk of developing a major complication was lower in
patients with depression, anxiety or both.
Median 7.5
years
Depression was associated with increased mortality and
cardiovascular events
LOS>=3
days
Anxiety increased pain and analgesic consumption .
Depression and comorbid depression increased mortality.
In-hospital mortality
LOS
Mortality
Mortality
Morbidity
Mortality
Depression increased both in-hospital mortality and LOS.
Depression decreased survival.
2 years.
6 months
Up to 60
month
6 months
Depression increased mortality.
Depression increased morbidity.
Depression increased mortality only in the subgroup of
patients with high-grade gliomas.
Depression increased mortality.
Mortality
Average
790 days
Depression increased mortality.
Mortality
Mean 6
years
Depression decreased survival.
("length of stay" OR "mortality" OR "morbidity" OR "complication*") AND depression AND surgery
# 2711 records (1778 if restricted to papers published from 2000)
# Performed on July, 17, 2014
# Restricted to: adult patients with non-bariatric surgery
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doi:10.1097/01.tp.0000268816.90672.a0.
Table S2. Patients’ characteristic, according to anxiety status
Variable
Socio-demographic characteristics
Age, mean (SD), years
Sex, male
Household: With others
Alone
Missing data
Marital status Married/cohabiting
Divorced
Single
Widowed
Missing data
Children None
One
Two
Three or more
Missing data
Works Full time
Part time
Retired
Unemployed
On sick leave
Missing data
Residence: House
Apartment with elevator
Apartment without elevator
Other
Missing data
Clinical and laboratory characteristics
BMI, mean (SD), kg/m²
Score ASA I
II
III
IV
AST, mean (SD), IU/mL
ALT, mean (SD), IU/mL
Bilirubin, mean (SD), μmol/L
Albumin mean (SD), g/L
Comorbidity
Depression (HADS-D ≥ 8)
History of depression
History of neuropsychological disorders
Use of antidepressants (lifetime)
HADS-A < 8
HADS-A ≥ 8
P-value
N= 353 (59.7) N= 238 (40.3)
58.1 (13.5)
208 (59.9)
279 (79.0)
58 (16.4)
16 (4.5)
254 (71.9)
35 (9.9)
21 (5.9)
19 (5.4)
24 (6.8)
69 (19.5)
55 (15.6)
122 (34.6)
105 (29.7)
2 (0.6)
82 (23.2)
19 (5.4)
166 (47.0)
14 (4.0)
48 (13.6)
24 (6.8)
211 (59.8)
68 (19.3)
29 (8.2)
7 (2.0)
38 (10.8)
58.4 (13.0)
111 (45.5)
192 (80.6)
38 (16.0)
8 (3.4)
167 (70.2)
20 (8.4)
19 (8.0)
17 (7.1)
15 (6.3)
61 (25.6)
42 (17.6)
81 (34.0)
52 (21.8)
2 (0.8)
53 (22.3)
8 (3.3)
118 (49.6)
15 (6.3)
25 (10.5)
19 (7.9)
129 (54.2)
47 (19.7)
41 (17.2)
0 (0.0)
21 (8.8)
0.78
<0.00
25.8 (5.0)
48 (13.6)
236 (66.8)
68 (19.3)
1 (0.3)
44.2 (72.9)
47.4 (55.5)
11.6 (9.2)
40.1 (5.5)
25.3 (4.4)
47 (19.7)
161 (67.6)
29 (12.2)
1 (0.4)
33.8 (24.9)
39.5 (36.3)
10.7 (9.8)
40.2 (4.5)
0.12
32 (9.1)
8 (2.3)
5 (1.3)
21 (5.9)
110 (46.2)
15 (6.3)
4 (1.7)
35 (14.7)
< 0.00
0.02
0.85
< 0.00
0.71
0.60
0.27
0.40
0.14
0.22
0.06
0.09
0.32
0.99
Data are expressed as counts unless otherwise stated; values within parentheses are percentages unless otherwise stated. ASA, American Society of
Anesthesiologists; AST, aspartate-aminotransferase; ALT, alanine-amino-transferase; BMI, body mass index; IQR, interquartile range; SD, standard deviation;
CCI, Comprehensive Complication Index.