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Trends and Outcomes of Coronary Artery Bypass Grafting in Patients with Major Depressive Disorder: A Perspective From The National Inpatient Sample
Andrew M. Del Re, BS, Krissia Rivera-Perla, MPH, Ghazal Aghagoli, ScB, Krishna Bellam, ScB, Afshin Ehsan, MD.
The Warren Alpert Medical School of Brown University, Providence, RI, USA.

BACKGROUND/OBJECTIVE: Major Depressive Disorder (MDD) is the most prevalent mental health disorder in the United States. We sought to determine the association between MDD and outcomes after coronary artery bypass grafting.
METHODS: The National Inpatient Sample was used to identify patients ≥18 years old that underwent coronary artery bypass grafting (CABG) from 2010-2017. Patients with a diagnosis of MDD were compared to those without MDD. Multivariable models were used to determine in-hospital outcomes for matched cohorts.
RESULTS: A total of 2,988,997 met criteria for inclusion including 108,782 with an MDD diagnosis. Most patients were male (71.46%), white (80.87%), and the average age was 66.3 years. After adjustment, patients with a diagnosis of MDD had lower odds of in-hospital mortality (p<0.001), and decreased odds of home discharge (p<0.001) after CABG. Patients with a diagnosis of MDD were also found to have lower odds of acute kidney injury (p<0.001), cardiogenic shock (p<0.001), infection (p<0.001), TIA/stroke (p=0.001), acute liver injury (p<0.001), and acute limb ischemia (p=0.003).
CONCLUSIONS: MDD is associated with a lower rate of postoperative in-hospital morbidity and mortality after CABG as well as a lower rate of home discharge. The etiology of this association is unknown but may be the result of MDD patients' earlier engagement with the healthcare system or less severe hospital course. Future prospective investigations are warranted to better characterize this association.


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