What does this research mean for the field?

Postoperative psychiatric disorders occur in 14.3% of surgical patients, with the highest risk observed in hip fracture surgery (aOR 2.34), and are associated with significantly increased healthcare utilization. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

The research aims to quantify the frequency and risk factors associated with postoperative depression and anxiety using large-scale data.

March 13, 2026

Exploring the Relationship Between Surgical Outcomes and Psychiatric Disorders: A Database Mining Study on Postoperative Depression and Anxiety.

Resultado clave

Postoperative psychiatric disorders occurred in 14.3% of surgical patients, with the highest risk in hip fracture surgery (aOR 2.34).

Puntos clave

The research aims to quantify the frequency and risk factors associated with postoperative depression and anxiety using large-scale data.
Conducted a retrospective cohort analysis using the HCUP-NIS database from 2016 to 2022.
Analyzed data from 4.2 million surgical procedures across 47 states.
Identified psychiatric disorders using ICD-10 codes within 30 days post-surgery.
Applied multivariable logistic regression and propensity score matching to assess associations.
14.3% of patients experienced newly coded postoperative psychiatric disorders.
Hip fracture surgery had the highest odds of psychiatric disorders (aOR 2.34).
Factors such as female sex and age >65 years were significantly associated with higher risk.
Significant disparities in healthcare utilization: longer hospital stays, higher readmission rates, and increased costs.

PICO estructurado

Does the development of postoperative psychiatric disorders increase healthcare utilization in patients undergoing surgical procedures?

Población

4.2 million surgical procedures across 47 states in the U.S. from the Healthcare Cost and Utilization Project National Inpatient Sample (HCUP-NIS) database (2016-2022).

Intervención

Development of newly coded postoperative psychiatric disorders (depression and anxiety) within 30 days post-surgery

Comparador

Patients without newly coded postoperative psychiatric disorders (propensity score matched 1:1 nearest neighbor)

Resultado

Frequency of newly coded postoperative psychiatric disorders within 30 days post-surgery, associated risk factors, and healthcare utilization (hospitalization length, 30-day readmission rates, and total costs)

Newly coded postoperative psychiatric disorders are common (14.3%) and significantly increase healthcare utilization, including longer hospital stays, higher readmission rates, and greater costs.

Resultado numérico

Tasa de eventos absoluta: 0% vs 0%

Resumen

ObjectiveThis study used population-scale administrative data to quantify the frequency, risk factors, and healthcare utilization implications of postoperative depression and anxiety.MethodsA retrospective cohort analysis was conducted using the U.S. Healthcare Cost and Utilization Project National Inpatient Sample (HCUP-NIS) database from 2016 to 2022, encompassing 4.2 million surgical procedures across 47 states. Newly coded postoperative psychiatric disorders were identified using ICD-10 diagnostic codes (F32. x for depression and F41.x for anxiety) within 30 days post-surgery. Multivariable logistic regression and propensity score matching (1:1 nearest neighbor, caliper width 0.2σ) were employed to evaluate associations between surgical characteristics and psychiatric outcomes, adjusting for demographics, comorbidities, and institutional factors.ResultsThe overall frequency of newly coded postoperative psychiatric disorders was 14.3%, including depression (9.1%), anxiety (8.7%), and mixed presentations (3.5%). Hip fracture surgery demonstrated the highest adjusted odds ratio (aOR 2.34, 95% CI = 2.18-2.51), followed by thoracotomy (aOR 1.89, 95% CI = 1.76-2.03) and cardiac procedures (aOR 1.67, 95% CI = 1.58-1.76). Significant associated factors included female sex (aOR 1.43, 95% CI = 1.39-1.47), age >65 years (aOR 1.28, 95% CI = 1.23-1.33), and operative duration exceeding 5 hours (aOR 1.52, 95% CI = 1.47-1.57). Propensity-matched analysis revealed substantial healthcare utilization disparities, including prolonged hospitalization (13.2 vs 8.4 days, P P P < 0.001).ConclusionsThis comprehensive population-based analysis demonstrated substantial heterogeneity in the risk of postoperative psychiatric disorders across surgical specialties, with profound implications for healthcare utilization. These findings support the implementation of systematic psychiatric screening protocols and targeted perioperative interventions for high-risk surgical populations.

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