Megan D Malueg,Esteban Quiceno,Mohamed A R Soliman,Ahmed Elbayomy,Alexander O Aguirre,Hannon W Levy,Asham Khan,Moleca M Ghannam,John Pollina,Jeffrey P Mullin
{"title":"腰椎融合术后精神障碍与围手术期结果的相关性:全国住院病人样本分析(2009-2020 年)》。","authors":"Megan D Malueg,Esteban Quiceno,Mohamed A R Soliman,Ahmed Elbayomy,Alexander O Aguirre,Hannon W Levy,Asham Khan,Moleca M Ghannam,John Pollina,Jeffrey P Mullin","doi":"10.1016/j.wneu.2024.09.010","DOIUrl":null,"url":null,"abstract":"BACKGROUND\r\nPreoperative diagnoses of psychiatric disorders have a demonstrated association with higher rates of perioperative complications. However, recent studies examining the influence of psychiatric disorders on lumbar fusion outcomes are scarce. Our objective was to determine the relationship between the most common psychiatric disorders and perioperative outcomes after lumbar fusion.\r\n\r\nMETHODS\r\nDemographic and perioperative data for patients who underwent lumbar spine fusion between 2009 and 2020 were collected from the National Inpatient Sample (NIS) database. These patients were divided into two groups: those who were previously diagnosed with depression, bipolar disorder, or anxiety, and those who were not. Univariable and multivariable linear and logistic regression models were utilized to analyze the data.\r\n\r\nRESULTS\r\nOf 2,877,241 patients identified in the NIS database as having undergone lumbar fusion, 647,951 had diagnosed psychiatric disorders, and the remaining 2,229,290 were the unaffected cohort. On multivariable analysis, patients diagnosed with psychiatric disorders had significantly increased odds of respiratory (odds ratio [OR]:1.09) and urinary (OR:1.08) complications, and experienced higher odds of mechanical injury (OR:1.27), fusion disorders (OR:1.62), dural tears (OR:1.08), postprocedure anemia (OR:1.29), longer hospital stays, and higher total costs, (p<0.001). Conversely, patients with psychiatric disorders had lower odds of neurologic injury (OR:0.8) and wound complications (OR:0.91) (p<0.05).\r\n\r\nCONCLUSION\r\nPatients with depression, bipolar disorder, or anxiety exhibited higher rates of certain types of complications. However, they appeared to have fewer neurological injuries and wound complications than patients without these psychiatric disorders. These findings highlight the necessity for additional studies to elucidate underlying reasons for these disparities.","PeriodicalId":23906,"journal":{"name":"World neurosurgery","volume":null,"pages":null},"PeriodicalIF":1.9000,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Correlations Between Psychiatric Disorders and Perioperative Outcomes after Lumbar Fusions: An Analysis of the National Inpatient Sample (2009-2020).\",\"authors\":\"Megan D Malueg,Esteban Quiceno,Mohamed A R Soliman,Ahmed Elbayomy,Alexander O Aguirre,Hannon W Levy,Asham Khan,Moleca M Ghannam,John Pollina,Jeffrey P Mullin\",\"doi\":\"10.1016/j.wneu.2024.09.010\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"BACKGROUND\\r\\nPreoperative diagnoses of psychiatric disorders have a demonstrated association with higher rates of perioperative complications. However, recent studies examining the influence of psychiatric disorders on lumbar fusion outcomes are scarce. Our objective was to determine the relationship between the most common psychiatric disorders and perioperative outcomes after lumbar fusion.\\r\\n\\r\\nMETHODS\\r\\nDemographic and perioperative data for patients who underwent lumbar spine fusion between 2009 and 2020 were collected from the National Inpatient Sample (NIS) database. These patients were divided into two groups: those who were previously diagnosed with depression, bipolar disorder, or anxiety, and those who were not. Univariable and multivariable linear and logistic regression models were utilized to analyze the data.\\r\\n\\r\\nRESULTS\\r\\nOf 2,877,241 patients identified in the NIS database as having undergone lumbar fusion, 647,951 had diagnosed psychiatric disorders, and the remaining 2,229,290 were the unaffected cohort. On multivariable analysis, patients diagnosed with psychiatric disorders had significantly increased odds of respiratory (odds ratio [OR]:1.09) and urinary (OR:1.08) complications, and experienced higher odds of mechanical injury (OR:1.27), fusion disorders (OR:1.62), dural tears (OR:1.08), postprocedure anemia (OR:1.29), longer hospital stays, and higher total costs, (p<0.001). Conversely, patients with psychiatric disorders had lower odds of neurologic injury (OR:0.8) and wound complications (OR:0.91) (p<0.05).\\r\\n\\r\\nCONCLUSION\\r\\nPatients with depression, bipolar disorder, or anxiety exhibited higher rates of certain types of complications. However, they appeared to have fewer neurological injuries and wound complications than patients without these psychiatric disorders. These findings highlight the necessity for additional studies to elucidate underlying reasons for these disparities.\",\"PeriodicalId\":23906,\"journal\":{\"name\":\"World neurosurgery\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2024-09-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"World neurosurgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.wneu.2024.09.010\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"World neurosurgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.wneu.2024.09.010","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Correlations Between Psychiatric Disorders and Perioperative Outcomes after Lumbar Fusions: An Analysis of the National Inpatient Sample (2009-2020).
BACKGROUND
Preoperative diagnoses of psychiatric disorders have a demonstrated association with higher rates of perioperative complications. However, recent studies examining the influence of psychiatric disorders on lumbar fusion outcomes are scarce. Our objective was to determine the relationship between the most common psychiatric disorders and perioperative outcomes after lumbar fusion.
METHODS
Demographic and perioperative data for patients who underwent lumbar spine fusion between 2009 and 2020 were collected from the National Inpatient Sample (NIS) database. These patients were divided into two groups: those who were previously diagnosed with depression, bipolar disorder, or anxiety, and those who were not. Univariable and multivariable linear and logistic regression models were utilized to analyze the data.
RESULTS
Of 2,877,241 patients identified in the NIS database as having undergone lumbar fusion, 647,951 had diagnosed psychiatric disorders, and the remaining 2,229,290 were the unaffected cohort. On multivariable analysis, patients diagnosed with psychiatric disorders had significantly increased odds of respiratory (odds ratio [OR]:1.09) and urinary (OR:1.08) complications, and experienced higher odds of mechanical injury (OR:1.27), fusion disorders (OR:1.62), dural tears (OR:1.08), postprocedure anemia (OR:1.29), longer hospital stays, and higher total costs, (p<0.001). Conversely, patients with psychiatric disorders had lower odds of neurologic injury (OR:0.8) and wound complications (OR:0.91) (p<0.05).
CONCLUSION
Patients with depression, bipolar disorder, or anxiety exhibited higher rates of certain types of complications. However, they appeared to have fewer neurological injuries and wound complications than patients without these psychiatric disorders. These findings highlight the necessity for additional studies to elucidate underlying reasons for these disparities.
期刊介绍:
World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review.
The journal''s mission is to:
-To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care.
-To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide.
-To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients.
Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS