脊柱转移性疾病患者中抑郁和焦虑的患病率。
The prevalence of depression and anxiety in patients with metastatic disease to the spine.
作者信息
Yeung Caleb, Heard Jeremy, Lee Yunsoo, McCurdy Michael, Narayanan Rajkishen, Kolowrat Samantha, Gibbons Liam, Hagan Tim, Canseco Jose A, Hilibrand Alan S, Vaccaro Alexander R, Schroeder Gregory D, Kepler Christopher K
机构信息
Department of Orthopaedic Surgery, Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, PA, USA.
出版信息
J Craniovertebr Junction Spine. 2024 Jul-Sep;15(3):308-314. doi: 10.4103/jcvjs.jcvjs_23_24. Epub 2024 Sep 12.
INTRODUCTION
The prevalence of depression and anxiety in cancer patients is approximately 15% and 20%. Unfortunately, depression has been demonstrated to negatively impact patients after spinal fusion surgeries and is associated with worse overall survival in cancer patients. The rates of depression and anxiety have yet to be reported in patients with metastatic spine disease. The objective of this study was to determine the rate of depression and anxiety in patients with metastatic spine disease.
MATERIALS AND METHODS
Patients >18 years of age at our institution who presented with metastatic spinal disease between 2017 and 2022 were identified through query search and verified by chart review of operative and biopsy notes. Patients who carried a depression and anxiety diagnosis were identified through a review of documentation in the electronic medical record. Demographic and surgical characteristics were recorded.
RESULTS
One hundred and fifty patients were identified. The average age and Charlson Comorbidity Index were 63.5 ± 13.0 and 8.34 ± 2.76, respectively. There were 84 (56.0%) males, 28 (18.7%) patients carrying a diagnosis of diabetes, and 40 (26.7%) current smokers. There were 127 (84.7%) surgeries performed for spinal metastases. The most common operative location was the thoracic spine (42.5%), while the sacrum was the least common (2.36%). Overall, 20.00% of our cohort carried a diagnosis of depression, 17.3% carried a diagnosis of anxiety, and 28.7% carried a diagnosis of either depression or anxiety. The most common primary cancers were lung (20.67%), breast (17.33%), and prostate cancers (15.33%).
CONCLUSION
Our study demonstrates elevated rates of depression and anxiety in patients with spinal metastatic disease relative to the general population. When evaluating patients with spinal metastases, spine surgeons have an opportunity to screen for symptoms and place an early referral to a mental health professional.
引言
癌症患者中抑郁症和焦虑症的患病率分别约为15%和20%。不幸的是，抑郁症已被证明会对脊柱融合手术后的患者产生负面影响，并且与癌症患者较差的总体生存率相关。转移性脊柱疾病患者的抑郁和焦虑发生率尚未见报道。本研究的目的是确定转移性脊柱疾病患者的抑郁和焦虑发生率。
材料与方法
通过查询搜索确定2017年至2022年间在我院就诊的年龄大于18岁的转移性脊柱疾病患者，并通过手术和活检记录的病历审查进行核实。通过审查电子病历中的文档确定患有抑郁症和焦虑症的患者。记录人口统计学和手术特征。
结果
共确定了150例患者。平均年龄和查尔森合并症指数分别为63.5±13.0和8.34±2.76。男性84例（56.0%），诊断为糖尿病的患者28例（18.7%），当前吸烟者40例（26.7%）。因脊柱转移瘤进行手术的有127例（84.7%）。最常见的手术部位是胸椎（42.5%），而骶骨最不常见（2.36%）。总体而言，我们的队列中有20.00%的患者被诊断为抑郁症，17.3%的患者被诊断为焦虑症，28.7%的患者被诊断为抑郁症或焦虑症。最常见的原发癌是肺癌（20.67%）、乳腺癌（17.33%）和前列腺癌（15.33%）。
结论
我们的研究表明，与普通人群相比，脊柱转移性疾病患者的抑郁和焦虑发生率更高。在评估脊柱转移瘤患者时，脊柱外科医生有机会筛查症状并尽早转诊至心理健康专业人员处。
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