Inflammatory indicator levels in patients undergoing aortic valve replacement via median sternotomy with preoperative anxiety and postoperative complications: a prospective cohort study

J Int Med Res. 2021 Feb;49(2):300060520977417. doi: 10.1177/0300060520977417.

Abstract

Objective: This study was performed to evaluate the association of preoperative anxiety with inflammatory indicators and postoperative complications in patients undergoing scheduled aortic valve replacement surgery.

Methods: A prospective cohort study was performed. The Hamilton Anxiety Scale was used to assess preoperative anxiety. The serum white blood cell (WBC) count and concentrations of C-reactive protein, interleukin (IL)-6, and IL-8 were measured 1 day preoperatively and 3 and 7 days postoperatively. Postoperative complications were also recorded.

Results: Seventy-three patients were included. The incidence of preoperative anxiety was 30.1% (22/73). The payment source was the only independent risk factor for preoperative anxiety. The incidence of postoperative complications was lowest in the mild anxiety group. The WBC count 3 days postoperatively was significantly lower in the mild than moderate-severe anxiety group. The IL-8 concentration 1 day preoperatively was highest in the no anxiety group.

Conclusions: Mild preoperative anxiety might help to improve clinical outcomes. However, further investigations with more patients are warranted. Patients with different degrees of anxiety may have different levels of inflammatory cytokines.

Keywords: Anxiety; clinical outcomes; cohort studies; heart valve prosthesis implantation; inflammation; postoperative complications.

MeSH terms

  • Anxiety / etiology
  • Aortic Valve* / surgery
  • Heart Valve Prosthesis Implantation* / adverse effects
  • Humans
  • Postoperative Complications / etiology
  • Prospective Studies
  • Sternotomy
  • Treatment Outcome