Correlations Between Psychiatric Disorders and Perioperative Outcomes after Lumbar Fusions: An Analysis of the National Inpatient Sample (2009-2020)

Authors

Megan D. Malueg, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA.
Esteban Quiceno, Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA; Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, New York, USA.
Mohamed A. Soliman, Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA; Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, New York, USA; Department of Neurosurgery, Faculty of Medicine, Cairo University, Cairo, Egypt.
Ahmed Elbayomy, Department of Neurological Surgery, University of Wisconsin School of Medicine and Public Health, Madison, USA.
Alexander O. Aguirre, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA.
Hannon W. Levy, The George Washington University School of Medicine and Health Sciences, Washington DC, USA.
Asham Khan, Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA; Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, New York, USA.
Moleca M. Ghannam, Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA; Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, New York, USA.
John Pollina, Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA; Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, New York, USA.
Jeffrey P. Mullin, Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences at University at Buffalo, Buffalo, New York, USA; Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, New York, USA. Electronic address: jmullin@ubns.com.

Document Type

Journal Article

Publication Date

9-10-2024

Journal

World neurosurgery

DOI

10.1016/j.wneu.2024.09.010

Keywords

Psychiatric disorders; lumbar fusion; national inpatient sample

Abstract

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.

APA Citation

Malueg, Megan D.; Quiceno, Esteban; Soliman, Mohamed A.; Elbayomy, Ahmed; Aguirre, Alexander O.; Levy, Hannon W.; Khan, Asham; Ghannam, Moleca M.; Pollina, John; and Mullin, Jeffrey P., "Correlations Between Psychiatric Disorders and Perioperative Outcomes after Lumbar Fusions: An Analysis of the National Inpatient Sample (2009-2020)" (2024). GW Authored Works. Paper 5650.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/5650

Department

School of Medicine and Health Sciences Student Works