Treatment with β-blockers and incidence of post-traumatic stress disorder after cardiac surgery: A prospective observational study

Objective: The aim was to investigate perioperative factors associated with the development of post-traumatic stress disorder (PTSD) in patients who underwent cardiac surgery. Design: Prospective observational study. Setting: Single academic center. Participants: One hundred twenty-eight consecutive patients scheduled for elective cardiac surgery with cardiopulmonary bypass. Interventions: Patients were interviewed within the surgical unit 1 to 3 days before cardiac surgery. Measurements and Main Results: Six months after surgery, participants were mailed the modified version of the Posttraumatic Stress Symptom Inventory 10. Of the 71 patients who completed the questionnaire and mailed it back at follow-up, 14 (19.7%) received a diagnosis of PTSD. Seven of 13 female patients who were not treated with β-blockers received a diagnosis of PTSD compared with 0 of 12 who were treated with β-blockers (p = 0.005, Fisher exact test). In a general linear model, including sex and β-blocker treatment as predictors, the Posttraumatic Stress Symptom Inventory 10 score was significantly predicted by β-blockade (F = 4.74, p = 0.033), with a significant interaction between sex and β-blockade (F = 9.72, p = 0.003). Conclusions: These findings suggest that the use of β-blockers might be protective against the development of PTSD in women after cardiac surgery. © 2012 Elsevier Inc