{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T05:45:31Z","timestamp":1789019131397,"version":"build-2803163510"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2021,10,4]],"date-time":"2021-10-04T00:00:00Z","timestamp":1633305600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005860","name":"Helsefonden","doi-asserted-by":"publisher","award":["16-B-0205"],"award-info":[{"award-number":["16-B-0205"]}],"id":[{"id":"10.13039\/501100005860","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007405","name":"Danish Heart Foundation","doi-asserted-by":"publisher","award":["18-R124- A8454-22099"],"award-info":[{"award-number":["18-R124- A8454-22099"]}],"id":[{"id":"10.13039\/100007405","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009926","name":"Fabrikant Karl G. Andersens Fond","doi-asserted-by":"crossref","award":["9292"],"award-info":[{"award-number":["9292"]}],"id":[{"id":"10.13039\/501100009926","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,1,18]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>\u2002<\/jats:title><\/jats:sec><jats:sec><jats:title>OBJECTIVES<\/jats:title><jats:p>Existing risk prediction models in cardiac surgery stratify individuals based on their predicted risk, including only medical and physiological factors. However, the complex nature of risk assessment and the lack of parameters representing non-medical aspects of patients\u2019 lives point towards the need for a broader paradigm in cardiac surgery. Objectives were to evaluate the predictive value of emotional and social factors on 4 outcomes; death within 90\u2009days, prolonged stay in intensive care (\u226572\u2009h), prolonged hospital admission (\u226510\u2009days) and readmission within 90\u2009days following cardiac surgery, as a supplement to traditional risk assessment by European System for Cardiac Operative Risk Evaluation (EuroSCORE).<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>The study included adults undergoing cardiac surgery in Denmark 2014\u20132017 including information on register-based socio-economic factors, and, in a nested subsample, self-reported symptoms of anxiety and depression. Logistic regression analyses were conducted, adjusted for EuroSCORE, of variables reflecting social and emotional factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Amongst 7874 included patients, lower educational level (odds ratio 1.33; 95% confidence interval 1.17\u20131.51) and living alone (1.25; 1.14\u20131.38) were associated with prolonged hospital admission after adjustment for EuroSCORE. Lower educational level was also associated with prolonged intensive care unit stay (1.27; 1.00\u20131.63). Having a high income was associated with decreased odds of prolonged hospital admission (0.78; 0.70\u20130.87). No associations or predictive value for symptoms of anxiety or depression were found on any outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Social disparity is predictive of poor outcomes following cardiac surgery. Symptoms of anxiety and depression are frequent especially amongst patients with a high-risk profile according to EuroSCORE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subj collection<\/jats:title><jats:p>105, 123<\/jats:p><\/jats:sec>","DOI":"10.1093\/icvts\/ivab261","type":"journal-article","created":{"date-parts":[[2021,9,30]],"date-time":"2021-09-30T19:56:44Z","timestamp":1633031804000},"page":"193-200","source":"Crossref","is-referenced-by-count":14,"title":["Social and emotional factors as predictors of poor outcomes following cardiac surgery"],"prefix":"10.1093","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0745-959X","authenticated-orcid":false,"given":"Pernille Fevejle","family":"Cromhout","sequence":"first","affiliation":[{"name":"Department of Cardiothoracic Anaesthesiology, Copenhagen University Hospital, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8375-5211","authenticated-orcid":false,"given":"Lau Caspar","family":"Thygesen","sequence":"additional","affiliation":[{"name":"The National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8609-4516","authenticated-orcid":false,"given":"Philip","family":"Moons","sequence":"additional","affiliation":[{"name":"Department of Public Health and Primary Care, KU Leuven - University of Leuven, Leuven, Belgium"},{"name":"Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden"},{"name":"Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4774-212X","authenticated-orcid":false,"given":"Samer","family":"Nashef","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Papworth Hospital, Cambridge, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7841-1449","authenticated-orcid":false,"given":"Sune","family":"Damgaard","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Surgery, Copenhagen University Hospital, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9493-954X","authenticated-orcid":false,"given":"Selina Kikkenborg","family":"Berg","sequence":"additional","affiliation":[{"name":"The National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark"},{"name":"Department of Cardiology, Copenhagen University Hospital, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,10,4]]},"reference":[{"key":"2022011823291591900_ivab261-B1","doi-asserted-by":"crossref","first-page":"1103","DOI":"10.1016\/j.ijcard.2015.11.034","article-title":"Patient selection for cardiac surgery: time to consider subgroups within risk categories?","volume":"203","author":"Van Giessen","year":"2016","journal-title":"Int J Cardiol"},{"key":"2022011823291591900_ivab261-B2","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/S1010-7940(99)00134-7","article-title":"European system for cardiac operative risk evaluation (EuroSCORE)","volume":"16","author":"Nashef","year":"1999","journal-title":"Eur J Cardiothorac Surg"},{"key":"2022011823291591900_ivab261-B3","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1161\/01.CIR.0000152102.29293.D7","article-title":"Patients with depressive symptoms have lower health status benefits after coronary artery bypass surgery","volume":"111","author":"Mallik","year":"2005","journal-title":"Circulation"},{"key":"2022011823291591900_ivab261-B4","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1016\/j.amjcard.2014.05.058","article-title":"Relation of major depression to survival after coronary artery bypass grafting","volume":"114","author":"Stenman","year":"2014","journal-title":"Am J Cardiol"},{"key":"2022011823291591900_ivab261-B5","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1161\/CIRCOUTCOMES.109.880377","article-title":"Socioeconomic position, not race, is linked to death after cardiac surgery","volume":"3","author":"Koch","year":"2010","journal-title":"Circ Cardiovasc Qual Outcomes"},{"key":"2022011823291591900_ivab261-B6","doi-asserted-by":"crossref","first-page":"e010137","DOI":"10.1136\/bmjopen-2015-010137","article-title":"Association between subjective social status and cardiovascular disease and cardiovascular risk factors: a systematic review and meta-analysis","volume":"6","author":"Tang","year":"2016","journal-title":"BMJ Open"},{"key":"2022011823291591900_ivab261-B7","doi-asserted-by":"crossref","first-page":"e026745","DOI":"10.1136\/bmjopen-2018-026745","article-title":"Updating EuroSCORE by including emotional, behavioural, social and functional factors to the risk assessment of patients undergoing cardiac surgery: a study protocol","volume":"9","author":"Cromhout","year":"2019","journal-title":"BMJ Open"},{"key":"2022011823291591900_ivab261-B8","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1177\/1474515118783835","article-title":"Time to expand risk evaluation systems for cardiac surgery? 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