Janis Bekeris1,2, Lauren A Wilson1, Megan Fiasconaro1, Jashvant Poeran3, Jiabin Liu1,4, Federico Girardi5, Stavros G Memtsoudis1,2,4,6. 1. Department of Anesthesiology, Critical Care & Pain Management, Hospital for Special Surgery, New York, NY. 2. Department of Anesthesiology, Perioperative Medicine and Intensive Care Medicine, Paracelsus Medical University, Salzburg, Austria. 3. Department of Population Health Science & Policy, Institute for Healthcare Delivery Science, Icahn School of Medicine at Mount Sinai, New York, NY. 4. Department of Anesthesiology, Weill Cornell Medicine, New York, NY. 5. Spine Surgery Service, Department of Orthopedic Surgery, Hospital for Special Surgery, New York, NY. 6. Department of Health Policy and Research, Weill Cornell Medical College, New York, NY.
Abstract
STUDY DESIGN: Retrospective database study. OBJECTIVE: We sought to investigate trends and risk factors for new-onset anxiety and/or depression within 6 months after elective spine surgery. SUMMARY OF BACKGROUND DATA: Surgery represents a stressful experience associated with a number of physiological and psychological consequences. A subset of patients develop clinically significant symptoms of new-onset anxiety or depression. However, the incidence of and risk factors for these adverse outcomes after spine surgery remain ill-defined. METHODS: We performed a retrospective analysis including anterior cervical discectomy and fusion and posterior lumbar fusion cases from 2012 to 2015, utilizing the Truven MarketScan database. Primary outcomes were new-onset depression, new-onset anxiety, and new-onset depression and/or anxiety after surgery. Potential risk factors included patient demographics, comorbidities, hospital and procedural characteristics as well as perioperative opioid regimens. Multivariable logistic regression models measured associations between risk factors and outcomes. Odds ratios (OR) were reported and results with P < 0.0167 were considered statistically significant. RESULTS: Among 39,495 unique patients, overall incidence of new-onset depression and anxiety was 6% and 11.2%, respectively. In adjusted analyses, significant risk factors across all three outcomes included chronic opioid use (ORs ranging from 1.31 to 2.93; P < 0.01), female sex (ORs ranging from 1.25 to 1.67; P < 0.01), longer length of stay (ORs ranging from 1.05 to 1.08; P < 0.01), and readmission within 6 months of surgery (OR ranging from 1.31 to 1.68; P < 0.01). CONCLUSION: We identified several risk factors contributing to increased odds of new-onset depression and/or anxiety after spine fusion surgery. These data may aid the implementation of preventative measures among identified high-risk patients. LEVEL OF EVIDENCE: 3.
STUDY DESIGN: Retrospective database study. OBJECTIVE: We sought to investigate trends and risk factors for new-onset anxiety and/or depression within 6 months after elective spine surgery. SUMMARY OF BACKGROUND DATA: Surgery represents a stressful experience associated with a number of physiological and psychological consequences. A subset of patients develop clinically significant symptoms of new-onset anxiety or depression. However, the incidence of and risk factors for these adverse outcomes after spine surgery remain ill-defined. METHODS: We performed a retrospective analysis including anterior cervical discectomy and fusion and posterior lumbar fusion cases from 2012 to 2015, utilizing the Truven MarketScan database. Primary outcomes were new-onset depression, new-onset anxiety, and new-onset depression and/or anxiety after surgery. Potential risk factors included patient demographics, comorbidities, hospital and procedural characteristics as well as perioperative opioid regimens. Multivariable logistic regression models measured associations between risk factors and outcomes. Odds ratios (OR) were reported and results with P < 0.0167 were considered statistically significant. RESULTS: Among 39,495 unique patients, overall incidence of new-onset depression and anxiety was 6% and 11.2%, respectively. In adjusted analyses, significant risk factors across all three outcomes included chronic opioid use (ORs ranging from 1.31 to 2.93; P < 0.01), female sex (ORs ranging from 1.25 to 1.67; P < 0.01), longer length of stay (ORs ranging from 1.05 to 1.08; P < 0.01), and readmission within 6 months of surgery (OR ranging from 1.31 to 1.68; P < 0.01). CONCLUSION: We identified several risk factors contributing to increased odds of new-onset depression and/or anxiety after spine fusion surgery. These data may aid the implementation of preventative measures among identified high-risk patients. LEVEL OF EVIDENCE: 3.
Authors: P Scarone; A Y J M Smeets; S M J van Kuijk; H van Santbrink; M Peters; E Koetsier Journal: BMC Musculoskelet Disord Date: 2020-12-04 Impact factor: 2.362
Authors: Elliot D K Cha; Conor P Lynch; James M Parrish; Nathaniel W Jenkins; Cara E Geoghegan; Caroline N Jadczak; Shruthi Mohan; Kern Singh Journal: Neurospine Date: 2021-03-31
Authors: Nitin K Prabhakar; Andrea L Chadwick; Chinwe Nwaneshiudu; Anuj Aggarwal; Vafi Salmasi; Theresa R Lii; Jennifer M Hah Journal: Int J Gen Med Date: 2022-05-02