Prevalence and Determinants of Death Anxiety Among Patients Awaiting Coronary Artery Bypass Grafting: An Analytical Cross-Sectional Study

Abstract

Objectives: Patients undergoing coronary artery bypass grafting (CABG) frequently experience substantial psychological distress, including death anxiety, which may influence surgical outcomes and recovery. Despite growing recognition, evidence from low- and middle-income countries (LMICs) remains limited. Aim of this study was to determine the prevalence and factors associated with death anxiety among patients recommended for CABG. Methodology: This analytical cross-sectional study was conducted at a tertiary care cardiac hospital in Muzaffarabad, Azad Jammu and Kashmir, from 1st April 2025 to 30th September 2025. A total of 190 patients aged 30–75 years were recruited using non-probability consecutive sampling. Data were collected through a structured questionnaire and the Templer Death Anxiety Scale (TDAS). Bivariate and multivariate logistic regression analyses were performed using SPSS version 26.0 to identify factors independently associated with high death anxiety. Results: The mean age of participants was 58.6 ± 9.8 years, with males comprising 67.4% of the sample. The prevalence of high death anxiety (TDAS ≥8) was 64.2%, with a mean score of 9.7 ± 3.1. Multivariate analysis identified female gender (AOR = 3.12), age >65 years (AOR = 2.74), no formal education (AOR = 4.05), low socioeconomic status (AOR = 2.63), diabetes mellitus (AOR = 2.21), triple-vessel disease (AOR = 2.98), prior myocardial infarction (AOR = 2.12), and CAD duration ≥5 years (AOR = 1.88) as significant factors associated with high death anxiety (p < 0.05). Conclusion: Death anxiety is highly prevalent among patients awaiting CABG and is associated with key socio-demographic and clinical factors. These findings highlight the need for integrating routine psychological assessment and targeted interventions into preoperative cardiac care, particularly in resource-limited settings.