SynthesisFrontiers in psychiatry2025
Meta-analysis of scar formation and depression and anxiety symptoms in patients after cardiac surgery.
Synthesis in Frontiers in psychiatry, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
3 authors.
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Abstract
Background: The vertical median skin scar associated with median sternotomy, a standard approach for most cardiac surgeries, can cause psychological distress in patients, particularly depression and anxiety. The impact of scarring after cardiac surgery on depression and anxiety symptoms in patients is not well understood. Aim: The purpose of this meta-analysis was to investigate the effect of scarring on depressive and anxiety symptoms in patients after cardiac surgery. Methods: To investigate the relationship between scar formation and depression and anxiety symptoms in patients after cardiac surgery. We searched databases such as Web of Science, Cochrane Library, PubMed, and Embase for studies published before August 2024 on scar descriptions and psychological states after cardiac surgery. After data extraction and quality assessment, we used RevMan5.4 to analyze the depression and anxiety symptoms of patients after scar formation. Two authors independently performed the focused analyses and reached a final consensus on the included studies, which were subsequently quality checked and risk of bias assessed by a third author. Results: Four studies were included in the meta-analysis. All 4 studies used Patient and Observer Scar Assessment Scale (POSAS) to assess scar, and one study also combined Vancouver Scar Scale (VSS) for scar assessment. Meta-analysis results show that Full sternotomy has a smaller scar score than Limited sternotomy (OR = 0.94 [95% confidence interval (CI) 0.28-1.61]; P = 0.005), and there is no significant heterogeneity between the two groups (I Conclusion: In conclusion, patients with more severe scarring after cardiac surgery may have more severe depressive symptoms, but adequately powered randomized controlled trials are needed to confirm these results.
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