Division of Spinal Surgery/Departments of Orthopaedic and Neurosurgery, NYU Medical Center, NY Spine Institute, New York, NY, USA.
Department of Orthopaedic Surgery, NYU Langone Orthopedic Hospital, New York, NY, USA.
J Clin Neurosci. 2021 Feb;84:42-45. doi: 10.1016/j.jocn.2020.11.049. Epub 2020 Dec 28.
Psychiatric diagnoses (PD) present a significant burden on elective surgery patients and may have potentially dramatic impacts on outcomes. As ailments of the spine can be particularly debilitating, the effect of PD on outcomes was compared between elective spine surgery patients and other common elective orthopedic surgery procedures. This study included 412,777 elective orthopedic patients who were concurrently diagnosed with PD within the years 2005 to 2016. 30.2% of PD patients experienced a post-operative complication, compared to 25.1% for non-PD patients (p < 0.001). Mood Disorders (bipolar or depressive disorders) were the most commonly diagnosed PD for all elective Orthopedic procedures, followed by anxiety, then dementia (p < 0.001). Logistic regression analysis found PD to be a significant predictor of higher cost to charge ratio (CCR), length of stay (LOS), and death (all p < 0.001). Between, hand, elbow, and shoulder specialties, spine patients had the highest odds of increased CCR and unfavorable discharge, and the second highest odds of death (all p < 0.001).
精神科诊断（PD）对择期手术患者造成了重大负担，并可能对结果产生潜在的重大影响。由于脊柱疾病可能特别使人虚弱，因此比较了 PD 对择期脊柱手术患者和其他常见的择期骨科手术的影响。这项研究包括 412,777 名在 2005 年至 2016 年期间同时被诊断为 PD 的择期骨科患者。与非 PD 患者（25.1%）相比，30.2%的 PD 患者术后出现并发症（p<0.001）。在所有择期骨科手术中，心境障碍（双相或抑郁障碍）是最常见的 PD 诊断，其次是焦虑症，然后是痴呆症（p<0.001）。逻辑回归分析发现 PD 是更高的成本收费比（CCR）、住院时间（LOS）和死亡（均 p<0.001）的显著预测因素。在手部、肘部和肩部专业中，脊柱患者的 CCR 增加和不利出院的几率最高，死亡的几率也位居第二（均 p<0.001）。
