Postoperative Anxiety and Depression Among Chinese Elderly Patients

Chinese PLA General Hospital8,590 enrolled

Overview

The goal of this observational study is to learn about the prevalence of postoperative anxiety and depression symptoms and identify the related risk factors in elderly patients aged 65 and older who undergo non-cardiac surgery in China. The main questions it aims to answer are: What is the prevalence rate of postoperative anxiety symptoms in elderly Chinese patients after non-cardiac surgery? What is the prevalence rate of postoperative depression symptoms in elderly Chinese patients after non-cardiac surgery? What are the risk and protective factors linked to postoperative anxiety and depression symptoms in this patient population? Participants will undergo routine non-cardiac surgery as part of their standard medical care, and researchers will collect relevant clinical data and assess their anxiety and depression symptoms using standardized screening scales after surgery.

This is a multicenter, retrospective observational study conducted across 19 medical centers in China, enrolling a total of 8590 elderly patients aged 65 years and above who received non-cardiac surgery between April 1, 2020, and April 30, 2022. The study was designed to fill the gap of lacking comprehensive epidemiological data on postoperative mental health disorders in this specific patient group in China, focusing on postoperative anxiety and depression symptoms that are tied to various adverse medical and social outcomes.

Study Type

OBSERVATIONAL

Enrollment

8,590

Conditions

Depression Anxiety

Eligibility

Sex: ALLMin age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. elderly patients (age ≥ 65 years) 2. undergoing elective surgery with a planned overnight hospital stay following surgery 3. non-cardiac surgery, non-neurosurgical surgery 4. patients who complete the scale assessment Exclusion Criteria: 1. patients fully refused to participate in the study 2. patients with severe dementia, language disorder, severe hearing or visual impairment, coma, and end-stage status 3. patients whose surgeries were canceled 4. history of previous severe mental illness or long-term use of psychotropic medications 5. patients admitted to ICU immediately after surgery 6. patients who died within 7 days after surgery

Outcomes

Primary Outcomes

Depression

Primary outcomes were depression Patient Health Questionnaire 9 (PHQ-9).The PHQ-9 is a nine-item questionnaire for screening on the presence of depressive symptoms and monitoring depression severity. Items were scored on a four-point scale with total scores ranging from zero to twenty-seven. Scores were defined as: ≥5 mild, ≥10 moderate, and ≥15 severe level of depression. The recommended screening cutoff was ≥10, corresponding with at least a moderate level of depression. The higher the score, the worse the situation. The total score ranges from 0 to 27, and higher scores indicate more depressive symptoms.

Time frame: within 7 days after surgery

Anxiety

The GAD-7 is a seven-item questionnaire for screening on the presence of generalized anxiety disorder and assessing its severity. Items were scored on a four-point scale with total scores ranging from zero to twenty-one. Scores were defined as: ≥5 mild, ≥10 moderate, and ≥15 severe anxiety. The recommended screening cutoff was ≥10, corresponding with at least a moderate level of anxiety. Higher scores mean more anxiety.