Anxiety and depression as risk factors for postoperative complications and pain in lumbar spine surgery: A national database study

IF 1.6 4区 医学 Journal of Orthopaedic Surgery Pub Date : 2024-09-18 DOI:10.1177/10225536241280190
Ruimin Wu, Pengcheng Gao, Shuxia Liu, Qinfeng Yang, Jian Wang, Fangguo Liang, Yuhang Chen, Lin Yang
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Abstract

Objective: To investigate the potential association between anxiety and depression and surgical outcomes in patients undergoing LSS. By analyzing data from the Nationwide Inpatient Sample (NIS) database, we aim to identify whether anxiety and depression serve as predictors for postoperative complications and pain-related symptoms. Methods: A retrospective analysis was conducted via the NIS database. Those undergoing LSS from 2010 to 2019 were divided into four groups: those with a diagnosis of anxiety, depression, both depression and anxiety, and neither depression nor anxiety. The chi-squared test, rank sum test, the Student-Newman-Keuls, least significant difference, and Bonferroni tests were used to identify differences between these groups. Logistic regression analysis was utilized to determine if anxiety and depression were predictors for postoperative complications and pain-related symptoms. Results: From 2010 to 2019, 832,099 patients undergoing LSS were identified. Patients with either anxiety or depression were associated with heavier economic burdens ($85,375, $76,840, $88,542 in the anxiety, depression, and comorbid group, respectively, p < 0.001) and prolonged hospital stay ( p < 0.001). They were identified to experience higher risks of various complications especially thrombophilia (OR = 1.82, and 1.55 in the anxiety and the depression group, respectively, p < 0.01). Multiple pain-related symptoms, but face reduced risks of inpatient mortality (OR = 0.71, 0.75, and 0.63 in the anxiety, depression, and comorbid group, respectively, p < 0.01). Conclusions: The overall morbidities of depression and anxiety were relatively high. Psychiatric comorbidities were closely correlated with the negative outcomes after LSS. The psychological health of patients receiving LSS requires necessary attention to ensure pain control and prevent complications postoperatively.
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焦虑和抑郁是腰椎手术术后并发症和疼痛的风险因素:国家数据库研究
目的研究焦虑和抑郁与 LSS 患者手术结果之间的潜在关联。通过分析全国住院患者样本(NIS)数据库中的数据,我们旨在确定焦虑和抑郁是否是术后并发症和疼痛相关症状的预测因素。研究方法通过 NIS 数据库进行回顾性分析。将 2010 年至 2019 年期间接受 LSS 的患者分为四组:诊断为焦虑、抑郁、抑郁和焦虑以及既无抑郁也无焦虑的患者。采用卡方检验、秩和检验、Student-Newman-Keuls 检验、最小显著性差异检验和 Bonferroni 检验来确定这些组间的差异。利用逻辑回归分析确定焦虑和抑郁是否是术后并发症和疼痛相关症状的预测因素。结果:从 2010 年到 2019 年,共有 832,099 名患者接受了 LSS 手术。焦虑或抑郁患者的经济负担更重(焦虑组、抑郁组和合并组分别为 85,375 美元、76,840 美元和 88,542 美元,p < 0.001),住院时间更长(p < 0.001)。研究还发现,他们出现各种并发症的风险较高,尤其是血栓性疾病(焦虑组和抑郁组的 OR 值分别为 1.82 和 1.55,p <0.01)。多种疼痛相关症状,但住院死亡率风险降低(焦虑组、抑郁组和合并症组的 OR 值分别为 0.71、0.75 和 0.63,p <0.01)。结论抑郁和焦虑的总体发病率相对较高。精神病合并症与 LSS 后的不良后果密切相关。为确保疼痛控制和预防术后并发症,LSS 患者的心理健康需要得到必要的关注。
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期刊介绍: Journal of Orthopaedic Surgery is an open access peer-reviewed journal publishing original reviews and research articles on all aspects of orthopaedic surgery. It is the official journal of the Asia Pacific Orthopaedic Association. The journal welcomes and will publish materials of a diverse nature, from basic science research to clinical trials and surgical techniques. The journal encourages contributions from all parts of the world, but special emphasis is given to research of particular relevance to the Asia Pacific region.
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