Context: Multilevel lumbar fusion use has increased with an aging U. S. population. Depression and psychotic disorders are linked to poorer surgical outcomes, but their effects in this setting are unclear. Aims: The aims of this study were to quantify the prevalence of these disorders and evaluate associations with perioperative outcomes and resource use. Settings and Design: This was a retrospective cohort study using the National Inpatient Sample from 2016 to 2022. Subjects and Methods: Depression and psychotic disorders were defined using Elixhauser-derived indicators. Outcomes included medical and mechanical complications, discharge disposition, length of stay (LOS), and costs. Statistical Analysis Used: Chi-square and logistic regression analyses were performed, with significance at the P < 0. 05 level. Results: Among 458, 180 weighted admissions, 18. 6% had depression and 2. 5% had psychoses. Compared to patients without these diagnoses, depression was associated with higher odds of cardiovascular complications (odds ratio OR: 1. 25, P < 0. 001), mechanical complications (OR: 1. 29, P < 0. 001), and nonhome discharge (OR: 1. 21, P < 0. 001). Psychoses were associated with higher odds of cardiovascular complications (OR: 1. 26, P < 0. 001), mechanical complications (OR: 1. 59, P < 0. 001), and nonhome discharge (OR: 1. 49, P < 0. 001). Compared with depression, psychoses had higher odds of mechanical complications (OR: 1. 21, P = 0. 016) and nonhome discharge (OR: 1. 27, P < 0. 001). The mean LOS increased stepwise (4. 3 vs. 4. 7 vs. 5. 1 days; P < 0. 001), and costs were higher (53, 200 vs. 55, 400 vs. 57, 900; P < 0. 001). Conclusions: Depression and psychotic disorders are common among patients undergoing multilevel lumbar fusion and are associated with higher healthcare utilization.
Mastrokostas et al. (Sun,) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: