Kostyun Regina O, Witmer Daniel K, Lucchio Peter, Solomito Matthew J
From the Hartford Hospital's Bone and Joint Institute, Hartford, CT (Kostyun, Witmer, Lucchio, and Solomito), and the Orthopedic Associates of Hartford, Hartford, CT (Dr. Witmer).
J Am Acad Orthop Surg. 2024 Dec 3. doi: 10.5435/JAAOS-D-24-00430.
Currently, few investigations explore the connection between global mental health and recovery following total hip arthroplasty (THA). The increased utilization of patient-reported outcomes tools provides an opportunity to assess a patient's mental health without undue survey burden. The purpose of this study was to explore how mental health is associated with a patient's immediate in-hospital recovery regardless of a formally diagnosed mental illness.
This retrospective study consisted of patients undergoing elective primary THA. Patients were grouped by both their PROMIS 10 Global Mental Health T-score (MHT) and whether they had a formally diagnosed mental illness. The resulting four patient groups were compared using multivariate regression analyses to determine differences in in-hospital pain reporting, opioid consumption, and discharge disposition.
One thousand four hundred and twenty nine patients were included in this study. MHT was an independent predictor of pain reporting at discharge (P < 0.001) and inpatient opioid consumption (P = 0.002). Regardless of the presence of mental illness, patients self-reporting poor mental health (MHT<40) reported higher pain levels, consumed more opioids, and were more likely to be discharged to a facility than those with an MHT >50.
Mental illness was not an independent predictor of immediate postoperative outcomes, but self-reported global mental health assessed using the MHT was. Therefore, surgeons should be aware of their patient's global mental health status before surgery because it is associated with in-hospital recovery following THA.
