Preoperative depression is associated with higher risk of bleeding in Type A Aortic Dissection repair: a population study of National Inpatient Sample from 2015-2020

P0266 

Abstract Submission 

Renxi Li (1), Qianyun Luo (2), Stephen Huddleston (2)

(1) The George Washington University, Washington, DC, (2) University of Minnesota, Minneapolis, MN

Renxi Li    -  Contact Me
The George Washington University

Qianyun Luo    -  Contact Me
University of Minnesota

Stephen Huddleston    -  Contact Me
University of Minnesota

Stephen Huddleston    -  Contact Me
N/A

Objective. Depression is highly prevalent in patients with aortic diseases. While depression has been shown to predispose patients to adverse outcomes after surgery, its impact on postoperative outcomes in Stanford Type A Aortic Dissection (TAAD) has not been established. This study aimed to conduct a population-based examination of the effect of preoperative depression on in-hospital outcomes after TAAD using the National/Nationwide Inpatient Sample (NIS) database, the largest all-layer database in the US.

Methods. Patients undergoing TAAD repair were identified in NIS from the last quarter of 2015-2020. Multivariable logistic regressions were used to compare in-hospital outcomes between patients with and without preoperative depression, adjusted for demographics, comorbidities, hospital characteristics, primary payer status, and transfer status.

Results. There were 321 (7.50%) patients with depression and 3,961 (92.50%) non-depressive patients who went under TAAD repair. Patients with and without depression had comparable in-hospital mortality (11.84% vs 15.37%, p=0.35). However, Patients with depression had a higher risk of hemorrhage/hematoma (83.49% vs 76.6%, aOR 1.593, 95 CI 1.161-2.184, p<0.01) and a higher rate of transfer out (40.81% vs 32.62%, aOR 1.396, 95 CI 1.077-1.81, p=0.01). All other in-hospital complications, hospital length of stay (LOS), and total hospital charge were all comparable between patients with and without depression.

Conclusion. Preoperative depression is associated with a higher risk of bleeding after TAAD repair. This may be due to anti-depression treatment, such as Selective Serotonin Reuptake Inhibitors (SSRIs), that can disrupt platelet function and lead to abnormal bleeding. While preoperative depression is not associated with other major outcomes, preoperative screening for depression before TAAD and corresponding preoperative blood management may be helpful in avoiding bleeding complications in patients with depression

Dissection