Journal article
Preoperative Patient Factors and Postoperative Complications as Risk Factors for New-Onset Depression Following Total Hip Arthroplasty
The Journal of arthroplasty, Vol.36(3), pp.1120-1125
03/2021
DOI: 10.1016/j.arth.2020.10.009
PMID: 33127239
Abstract
Depression is known to be a risk factor for complication following primary total hip arthroplasty (THA), but little is known about new-onset depression (NOD) following THA. The purpose of this study is to determine the incidence of NOD and identify risk factors for its occurrence after THA.
This is a retrospective cohort study of the Truven MarketScan database. Patients undergoing primary THA were identified and separated into cohorts based on the presence or not of NOD. Patients with preoperative depression or a diagnosis of fracture were excluded. Patient demographic and comorbid data were queried, and postoperative complications were collected. Univariate and multivariate regression analysis was then performed to assess the association of NOD with patient-specific factors and postoperative complications.
In total, 111,838 patients undergoing THA were identified and 2517 (2.25%) patients had NOD in the first postoperative year. Multivariate analysis demonstrated that preoperative opioid use, female gender, higher Elixhauser comorbidity index, preoperative anxiety disorder, drug or alcohol use disorder, and preoperative smoking were associated with the occurrence of NOD (P ≤ .001). The following postoperative complications were associated with increased odds of NOD: prosthetic joint infection (odds ratio [OR] 1.82, 95% confidence interval [CI] 1.42-2.34, P < .001), aseptic revision surgery (OR 1.47, 95% CI 1.06-2.04, P = .019), periprosthetic fracture (OR 1.72, 95% CI 1.13-2.61, P = .01), and non-home discharge (OR 1.59, 95% CI 1.42-1.77, P < .001).
NOD is common following THA and there are multiple patient-specific factors and postoperative complications which increase the odds of its occurrence. Providers should use this information to identify at-risk patients so that pre-emptive prevention strategies may be employed.
Details
- Title: Subtitle
- Preoperative Patient Factors and Postoperative Complications as Risk Factors for New-Onset Depression Following Total Hip Arthroplasty
- Creators
- Jacob M Wilson - Emory UniversityAndrew M Schwartz - Emory UniversityKevin X Farley - Emory UniversityThomas L Bradbury - Emory UniversityGeorge N Guild - Emory University
- Resource Type
- Journal article
- Publication Details
- The Journal of arthroplasty, Vol.36(3), pp.1120-1125
- DOI
- 10.1016/j.arth.2020.10.009
- PMID
- 33127239
- ISSN
- 0883-5403
- eISSN
- 1532-8406
- Language
- English
- Date published
- 03/2021
- Academic Unit
- Orthopedics and Rehabilitation
- Record Identifier
- 9984303965102771
Metrics
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