Kevin J Cronin1, Scott D Mair2, Greg S Hawk3, Katherine L Thompson3, Carolyn M Hettrich4, Cale A Jacobs2. 1. Department of Orthopaedic Surgery & Sports Medicine, University of Kentucky, Lexington, Kentucky, U.S.A.. Electronic address: Kevin.Cronin@uky.edu. 2. Department of Orthopaedic Surgery & Sports Medicine, University of Kentucky, Lexington, Kentucky, U.S.A. 3. Department of Statistics, University of Kentucky, Lexington, Kentucky, U.S.A. 4. Brigham and Women's Hospital, Boston, Massachusetts, U.S.A.
Abstract
PURPOSE: To (1) quantify the prevalence of mood disorders in patients undergoing arthroscopic rotator cuff repair (RCR) by use of a large claims database and (2) compare opioid use and medical costs in the year before and the year after RCR between patients with and without comorbid mood disorders. METHODS: A large claims database was queried to identify patients who underwent arthroscopic RCR (Current Procedural Terminology code 29827) between October 2010 and December 2015. All patients were then screened for insurance claims relating to either anxiety or depression. We compared net costs and opioid use both 1 year preoperatively and 1 year postoperatively between patients with and without mood disorders by use of an analysis of covariance. RESULTS: A total of 170,329 patients (97,427 male patients [57.2%] and 72,902 female patients [42.8%]) undergoing arthroscopic RCR were identified. Of the 170,329 patients, 46,737 (27.4%) had comorbid anxiety or depression, and after adjustment for preoperative cost, sex, age, and both preoperative and postoperative opioid use, the 1-year postoperative cost was 7.05% higher for those with a preoperative mood disorder than for those without a mood disorder. In addition, opioid use both in the 180 days prior to surgery (36.7% vs 26.9%) and more than 90 days after surgery (33.0% vs 27.2%) was substantially greater in the group with comorbid depression or anxiety. CONCLUSIONS: In patients with comorbid mood disorders, opioid use and health care costs were increased both preoperatively and postoperatively. The increased cost in this patient population is estimated at $62.3 million annually. In an effort to provide high-quality, value-based care, treatment strategies should be developed to identify these patients preoperatively and provide the appropriate resources needed to improve the probability of a successful surgical outcome. LEVEL OF EVIDENCE: Level III, retrospective, comparative therapeutic study.
PURPOSE: To (1) quantify the prevalence of mood disorders in patients undergoing arthroscopic rotator cuff repair (RCR) by use of a large claims database and (2) compare opioid use and medical costs in the year before and the year after RCR between patients with and without comorbid mood disorders. METHODS: A large claims database was queried to identify patients who underwent arthroscopic RCR (Current Procedural Terminology code 29827) between October 2010 and December 2015. All patients were then screened for insurance claims relating to either anxiety or depression. We compared net costs and opioid use both 1 year preoperatively and 1 year postoperatively between patients with and without mood disorders by use of an analysis of covariance. RESULTS: A total of 170,329 patients (97,427 male patients [57.2%] and 72,902 female patients [42.8%]) undergoing arthroscopic RCR were identified. Of the 170,329 patients, 46,737 (27.4%) had comorbid anxiety or depression, and after adjustment for preoperative cost, sex, age, and both preoperative and postoperative opioid use, the 1-year postoperative cost was 7.05% higher for those with a preoperative mood disorder than for those without a mood disorder. In addition, opioid use both in the 180 days prior to surgery (36.7% vs 26.9%) and more than 90 days after surgery (33.0% vs 27.2%) was substantially greater in the group with comorbid depression or anxiety. CONCLUSIONS: In patients with comorbid mood disorders, opioid use and health care costs were increased both preoperatively and postoperatively. The increased cost in this patient population is estimated at $62.3 million annually. In an effort to provide high-quality, value-based care, treatment strategies should be developed to identify these patients preoperatively and provide the appropriate resources needed to improve the probability of a successful surgical outcome. LEVEL OF EVIDENCE: Level III, retrospective, comparative therapeutic study.
Authors: K L Smith; D T Harryman; J Antoniou; B Campbell; J A Sidles; F A Matsen Journal: J Shoulder Elbow Surg Date: 2000 Sep-Oct Impact factor: 3.019
Authors: Cale A Jacobs; Jeremy M Burnham; Kate N Jochimsen; Domingo Molina; David A Hamilton; Stephen T Duncan Journal: J Arthroplasty Date: 2017-07-08 Impact factor: 4.757
Authors: Nicholas A Bedard; Spencer B Dowdle; Christopher A Anthony; David E DeMik; Michael A McHugh; Kevin J Bozic; John J Callaghan Journal: J Arthroplasty Date: 2017-01-18 Impact factor: 4.757
Authors: Nikoo Saveh Shemshaki; Ho-Man Kan; Mohammed Barajaa; Takayoshi Otsuka; Amir Lebaschi; Neha Mishra; Lakshmi S Nair; Cato T Laurencin Journal: Proc Natl Acad Sci U S A Date: 2022-08-08 Impact factor: 12.779
Authors: Austin V Stone; Meredith L Murphy; Cale A Jacobs; Christian Lattermann; Gregory S Hawk; Katherine L Thompson; Caitlin E W Conley Journal: Cartilage Date: 2022 Jan-Mar Impact factor: 3.117