Background
This study examined the effects of the use of anxiolytic medications (AXM) and antidepressant
medications (ADMs) on outcomes after noncardiac surgery.
Study design
A single-center review of prospectively obtained, perioperative and 30-day outcome
data, including AXM and ADM use at admission, as part of the National Surgery Quality
Improvement Program.
Results
Of the 1846 patients undergoing surgery, 380 (20.6%) were taking an ADM, 288 (15.6%)
AXM, 124 (6.7%) were taking both, and 545 (29.5%) were taking either at the time of
admission. Both ADM and AXM patients more often were female than nonusers, had a greater
American Society of Anesthesiologists class and suffered more from hypertension, COPD,
and dyspnea (all P < .005). AXM patients also were more often smokers. ADM patients had a greater mortality
and a greater risk of an infective complication, but these effects did not remain
after adjustment for procedure and comorbid risks. Patients taking AXM had greater
duration of stay, as well as an increased incidence of return to the operating room,
infections, wound occurrences, and cardiovascular or cerebrovascular events (all P < .005). After adjustment, AXM was associated with greater combined major morbidity
or mortality (odds ratio 1.72, 95% confidence interval 1.08–2.73, P = .023).
Conclusion
AXM was used by 16% of patients in our institution undergoing a noncardiac operation
and was an independent risk factor for poorer short-term outcome after surgery. ADM
was found to be used by 21% of patients but was not an independent risk factor for
poor outcome.
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Article info
Publication history
Published online: May 29, 2015
Accepted:
March 16,
2015
Identification
Copyright
© 2015 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
