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J Psychosom Res. 2014 Jan;76(1):34-40. doi: 10.1016/j.jpsychores.2013.10.019. Epub 2013 Nov 6.

The combined association of depression and socioeconomic status with length of post-operative hospital stay following coronary artery bypass graft surgery: data from a prospective cohort study.

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Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, UK. Electronic address:
Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, UK.
Department of Cardiac Surgery, St George's Hospital, University of London, Blackshaw Road, London, UK.



To understand the association between pre-operative depression symptoms, including cognitive and somatic symptom subtypes, and length of post-operative stay in patients undergoing coronary artery bypass graft (CABG) surgery, and the role of socioeconomic status (SES).


We measured depression symptoms using the Beck Depression Inventory (BDI) and household income in the month prior to surgery in 310 participants undergoing elective, first-time, CABG. Participants were followed-up post-operatively to assess the length of their hospital stay.


We showed that greater pre-operative depression symptoms on the BDI were associated with a longer hospital stay (hazard ratio=0.978, 95% CI 0.957-0.999, p=.043) even after controlling for covariates, with the effect being observed for cognitive symptoms of depression but not somatic symptoms. Lower SES augmented the negative effect of depression on length of stay.


Depression symptoms interact with socioeconomic position to affect recovery following cardiac surgery and further work is needed in order to understand the pathways of this association.


ACS; ARCS study; Adjustment and Recovery after Cardiac Surgery study; BDI; BMI; Beck Depression Inventory; CABG; CI; Coronary artery bypass graft surgery; Depression; EuroSCORE; European System for Cardiac Operative Risk Evaluation; HADS; Hospital Anxiety and Depression Scale; Income; Length of stay; Recovery; Socioeconomic position; acute coronary syndrome; body mass index; confidence intervals; coronary artery bypass graft

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