Social, clinical, and surgical predictors of delayed return to routine post-cardiac surgery - The 68th Annual Conference of the Israel Heart Society in association with the Israel Society of Cardiothoracic Surgery

Amanda Sinderovsky ^1,2 Illana Posen ^1,2,3 Liza Grosman-Rimon ^1,3 Noa Caspi-Avissar ¹ Dina Granot ¹ Alla Lubovich ^1,4 Doron Sudarsky ^1,4 Sagi Gleitman ¹ Michael Gelbstein ¹ Wadi Kinany ¹ Fabio Kusniec ^1,4 Ibrahim Marai ^1,4 Erez Kachel ^1,4,5 Shemy Carasso ^1,4 Edo Birati ^1,4

¹Division of Cardiovascular Medicine and Surgery, Poriya Medical Center, Israel
²The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Israel
³The Academic College at Wingate, Wingate Institute, Israel
⁴The Azrieli Faculty of Medicine, Bar-Ilan University, Israel
⁵Department of Cardiac Surgery, Sheba Medical Centre, Israel

Objective: Return to work and routine after cardiac surgery is an indicator of surgical success. The objective of this study was to assess predictors of delayed return to routine after cardiac surgery.

Methods: Socio-demographic, clinical, and surgical data were collected for (n=100) cardiac surgery patients using patient charts and electronic medical records. The return to routine categories were assessed with a questionnaire that asked if patients returned to work, hobbies, social interaction, and independence after surgery. Return to routine was measured as (1) Regular Return; (2) Almost Returning; (3) Moderate; (4) Little; (5) Not at all. Linear univariable and multivariable analyses were performed to define factors associated with delay return to routine scores at both 2 and 6 weeks.

Results: At 2 weeks post-surgery, female sex (p=0.001), not participating in cardiac rehabilitation (p=0.032), higher depression score (p<0.001) and lower economic situation (p=0.004) predicted delayed return to independent status. Combined surgery type (CAB-G and valve surgery) (p=0.004) and higher depression score (p=0.002) predicted delayed return to social participation. Higher depression score predicted delayed return to both hobbies (p=0.003) and work (p=0.045) 2 weeks post-surgery. At 6 weeks post-surgery, female sex (p=0.003), diabetes (p=0.007), lower level of education (p=0.018) and higher depression score (p<0.001) predicted delayed return to independence. Female sex (p=0.003), depression score (p<0.001) and lower economic status (p=0.013) predicted delayed return to social participation. Female sex (p=0.023), lower depression score (p<0.001) and lower economic status (p=0.033) predicted delayed return to hobbies, while lower level of education (p=0.043), not participating in cardiac rehabilitation (p=0.036) and higher depression score (p<0.001) predicted delayed return to work 6 weeks post-surgery.

Conclusion: Depression score was significantly associated with delayed return to routine in all categories, suggesting that evaluation and management of depressive symptoms in patients post cardiac surgery are important for successful return to routine.