Impact of Psychiatric Comorbidities on Short-Term Outcomes Following Intervention for Lumbar Degenerative Disc Disease

Piyush Kalakoti; Daniel M Sciubba; Andrew J Pugely; Matthew J McGirt; Kanika Sharma; Devi P Patra; Kevin Phan; Karthik Madhavan; Richard P Menger; Christina Notarianni; Bharat Guthikonda; Anil Nanda; Hai Sun

doi:10.1097/BRS.0000000000002616

Back

Impact of Psychiatric Comorbidities on Short-Term Outcomes Following Intervention for Lumbar Degenerative Disc Disease

Journal article

Peer reviewed

Impact of Psychiatric Comorbidities on Short-Term Outcomes Following Intervention for Lumbar Degenerative Disc Disease

Piyush Kalakoti, Daniel M Sciubba, Andrew J Pugely, Matthew J McGirt, Kanika Sharma, Devi P Patra, Kevin Phan, Karthik Madhavan, Richard P Menger, Christina Notarianni, …

Spine (Philadelphia, Pa. 1976), Vol.43(19), pp.1363-1371

10/01/2018

DOI: 10.1097/BRS.0000000000002616

PMID: 29481379

View Online

Abstract

Retrospective, observational cohort study. To investigate the impact of psychiatric diseases on short-term outcomes in patients undergoing fusion surgery for lumbar degenerative disc disease (LDDD). Limited literature exists on the prevalence and impact of psychiatric comorbidities on outcomes in patients undergoing surgery for LDDD. Adult patients (>18 yr) registered in the Nationwide Inpatient Sample database (2002-2011) and undergoing an elective spine fusion for LDDD that met inclusion criteria formed the study population. Defined primary outcome measures were discharge disposition, length of stay, hospitalization cost, and short-term postsurgical complications (neurological, respiratory, cardiac, gastrointestinal, wound complication and infections, venous thromboembolism, and acute renal failure). Multivariable regression techniques were used to explore the association of psychiatric comorbidities on short-term outcomes by adjusting for patient demographics, clinical, and hospital characteristics. Of the 126,044 adult patients undergoing fusion surgery for LDDD (mean age: 54.91 yr, 58% female) approximately 18% had a psychiatric disease. Multivariable regression analysis revealed patients with psychiatric disease undergoing fusion surgery have higher likelihood for unfavorable discharge (odds ratio [OR] 1.41; 95% confidence interval [CI] 1.35-1.47; P < 0.001), length of stay (OR 1.03; 95% CI 1.02-1.04; P < 0001), postsurgery neurologic complications (OR 1.25; 95% CI 1.13-1.37; P < 0.001), venous thromboembolic events (OR 1.38 95% CI 1.26-1.52; P < 0.001), and acute renal failure (OR 1.17; 95% CI 1.01-1.37; P = 0.040). Patients with psychiatric disease were also associated to have higher hospitalization cost (6.3% higher; 95% CI: 5.6%-7.1%; P < 0.001) compared to those without it. Our study quantifies the estimates for presence of concomitant psychiatric comorbid conditions on short outcomes in patients undergoing fusions for LDDD. The data provide supporting evidence for adequate preoperative planning and postsurgical care including consultation for mental health for favorable outcomes. 4.

Length of Stay

Intervertebral Disc Degeneration - surgery

Humans

Middle Aged

Patient Discharge

Male

Mental Disorders - complications

Treatment Outcome

Spinal Fusion

Intervertebral Disc Degeneration - complications

Lumbar Vertebrae - surgery

Mental Disorders - surgery

Adult

Female

Aged

Retrospective Studies

Details

Title: Subtitle: Impact of Psychiatric Comorbidities on Short-Term Outcomes Following Intervention for Lumbar Degenerative Disc Disease
Creators: Piyush Kalakoti - Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, LA
Daniel M Sciubba - Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD
Andrew J Pugely - Department of Spine Surgery, Orthopedics and Rehabilitation, University of Iowa, Iowa City, IA
Matthew J McGirt - Department of Neurological Surgery, Carolina Neurosurgery and Spine Associates, Charlotte, NC
Kanika Sharma - Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, LA
Devi P Patra - Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, LA
Kevin Phan - NeuroSpine Surgery Research Group (NSURG), Sydney, Australia
Karthik Madhavan - Department of Neurosurgery, Miller School of Medicine, University of Miami, FL
Richard P Menger - Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, LA
Christina Notarianni - Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, LA
Bharat Guthikonda - Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, LA
Anil Nanda - Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, LA
Hai Sun - Department of Neurosurgery, Louisiana State University Health Sciences Center, Shreveport, LA
Resource Type: Journal article
Publication Details: Spine (Philadelphia, Pa. 1976), Vol.43(19), pp.1363-1371
DOI: 10.1097/BRS.0000000000002616
PMID: 29481379
NLM abbreviation: Spine (Phila Pa 1976)
ISSN: 0362-2436
eISSN: 1528-1159
Publisher: Lippincott Williams & Wilkins; United States
Language: English
Date published: 10/01/2018
Academic Unit: Orthopedics and Rehabilitation
Record Identifier: 9984040493502771

Metrics

16 Record Views

15 Times Cited - Web of Science

See more details