Shalaeva, Evgeniya; Bano, Arjola; Kasimov, Ulugbek; Atakov, Sarvar; Mirakhmedova, Khilola; Dadabaeva, Nailya; Laimer, Markus; Saner, Hugo (2024). Depression and anxiety symptoms are underestimated risk factors for postoperative prognosis in patients with Type 2 diabetes and peripheral artery disease undergoing partial foot amputation: Results from a prospective cohort study. Journal of psychosomatic research, 183, p. 111824. Elsevier 10.1016/j.jpsychores.2024.111824
![[img]](https://boris.unibe.ch/style/images/fileicons/text.png) |
Text
1-s2.0-S0022399924002368-main.pdf - Published Version Restricted to registered users only Available under License Publisher holds Copyright. Download (1MB) |
|
Text
Shalaeva_JPsychosomRes_2024_AAM.pdf - Accepted Version Restricted to registered users only until 7 June 2025. Available under License Publisher holds Copyright. Download (543kB) |
OBJECTIVE
The aim of this study was to evaluate the prevalence and impact of depression and anxiety symptoms on post-operative prognosis and 1-year all-cause mortality in a large unique cohort of patients with Type 2 diabetes (T2D) and peripheral artery disease (PAD) after partial foot amputation (PFA).
METHODS
Prospective cohort study with 1-year follow-up of 785 consecutive patients (mean age 60.9 ± 9.1 years; 64.1% males) with T2D and PAD after PFA. Depressive symptoms were assessed by Patient Health Questionnaire-9 (PHQ-9) and anxiety symptoms by Hamilton Anxiety Rating Scale (HARS). We used multivariable Cox proportional hazard models to examine the association of depression and anxiety with all-cause mortality.
RESULTS
One-year all-cause mortality was 16.9% (n = 133). 331 (42.1%) patients had PHQ-9 score ≥ 10 indicating major depressive disorder. After adjusting for confounders, PHQ-9 score ≥ 10 was associated with an increased risk of 1-year all-cause mortality (HR = 1.68 (95%CI[1.16-2.44], p = 0.006). Depression dimensions of negative self-feeling and suicidal ideations were independently associated with 1-year mortality (HR = 1.26 (95%CI[1.24-1.55], p = 0.029 and HR = 2.37 (95%CI[1.89-2.96], p < 0.001, respectively). Compared to no depression, severe depressive symptoms (cut-off≥20) were associated with increased all-cause mortality (HR = 3.9 (95%CI [1.48-10.29], p = 0.006). Compared to no anxiety, severe anxiety symptoms (cut-off>30) were associated with increased 1-year mortality (HR = 2.25(95%CI [1.26-4.05], p = 0.006).
CONCLUSION
Depressive symptoms and severe anxiety have shown independently increased risk of 1-year all-cause mortality in patients with T2D and PAD requiring PFA. Our results indicate that screening for anxiety and depression should be considered under these circumstances to identify patients at increased risk to allow appropriate intervention.
Actions (login required)
 |
Edit item |