Consequences of the prolonged waiting time for patient candidates for heart surgery

Arq Bras Cardiol. 2002 May;78(5):452-65. doi: 10.1590/s0066-782x2002000500003.
[Article in English, Portuguese]

Abstract

Objective: To assess mortality and the psychological repercussions of the prolonged waiting time for candidates for heart surgery.

Methods: From July 1999 to May 2000, using a standardized questionnaire, we carried out standardized interviews and semi-structured psychological interviews with 484 patients with coronary heart disease, 121 patients with valvular heart diseases, and 100 patients with congenital heart diseases.

Results: The coefficients of mortality (deaths per 100 patients/year) were as follows: patients with coronary heart disease, 5.6; patients with valvular heart diseases, 12.8; and patients with congenital heart diseases, 3.1 (p<0.0001). The survival curve was lower in patients with valvular heart diseases than in patients with coronary heart disease and congenital heart diseases (p<0.001). The accumulated probability of not undergoing surgery was higher in patients with valvular heart diseases than in the other patients (p<0.001), and, among the patients with valvular heart diseases, this probability was higher in females than in males (p<0.01). Several patients experienced intense anxiety and attributed their adaptive problems in the scope of love, professional, and social lives, to not undergoing surgery.

Conclusion: Mortality was high, and even higher among the patients with valvular heart diseases, with negative psychological and social repercussions.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Brazil / epidemiology
  • Cardiac Surgical Procedures
  • Coronary Disease / mortality
  • Coronary Disease / psychology
  • Coronary Disease / surgery
  • Female
  • Heart Defects, Congenital / mortality
  • Heart Defects, Congenital / psychology
  • Heart Diseases / mortality*
  • Heart Diseases / psychology
  • Heart Valve Diseases / mortality
  • Heart Valve Diseases / psychology
  • Humans
  • Interviews as Topic
  • Male
  • Middle Aged
  • Myocardial Revascularization
  • Survival Analysis
  • Time Factors
  • Waiting Lists*