Impact of Psychiatric Comorbidities on Short-Term Outcomes Following Intervention for Lumbar Degenerative Disc Disease

Piyush Kalakoti, Daniel Sciubba, Andrew J. Pugely, Matthew J. McGirt, Kanika Sharma, Devi P. Patra, Kevin Phan, Karthik Madhavan, Richard P. Menger, Christina Notarianni, Bharat Guthikonda, Anil Nanda, Hai Sun

Research output: Contribution to journalArticle

Abstract

CONCLUSION: Our study quantifies the estimates for presence of concomitant psychiatric comorbid conditions on short outcomes in patients undergoing fusions for LDDD. The data provide supporting evidence for adequate preoperative planning and postsurgical care including consultation for mental health for favorable outcomes.4.

STUDY DESIGN: Retrospective, observational cohort study.

OBJECTIVE: To investigate the impact of psychiatric diseases on short-term outcomes in patients undergoing fusion surgery for lumbar degenerative disc disease (LDDD).

SUMMARY OF BACKGROUND DATA: Limited literature exists on the prevalence and impact of psychiatric comorbidities on outcomes in patients undergoing surgery for LDDD.

METHODS: Adult patients (>18 yr) registered in the Nationwide Inpatient Sample database (2002-2011) and undergoing an elective spine fusion for LDDD that met inclusion criteria formed the study population. Defined primary outcome measures were discharge disposition, length of stay, hospitalization cost, and short-term postsurgical complications (neurological, respiratory, cardiac, gastrointestinal, wound complication and infections, venous thromboembolism, and acute renal failure). Multivariable regression techniques were used to explore the association of psychiatric comorbidities on short-term outcomes by adjusting for patient demographics, clinical, and hospital characteristics.

RESULTS: Of the 126,044 adult patients undergoing fusion surgery for LDDD (mean age: 54.91 yr, 58% female) approximately 18% had a psychiatric disease. Multivariable regression analysis revealed patients with psychiatric disease undergoing fusion surgery have higher likelihood for unfavorable discharge (odds ratio [OR] 1.41; 95% confidence interval [CI] 1.35-1.47; P < 0.001), length of stay (OR 1.03; 95% CI 1.02-1.04; P < 0001), postsurgery neurologic complications (OR 1.25; 95% CI 1.13-1.37; P < 0.001), venous thromboembolic events (OR 1.38 95% CI 1.26-1.52; P < 0.001), and acute renal failure (OR 1.17; 95% CI 1.01-1.37; P = 0.040). Patients with psychiatric disease were also associated to have higher hospitalization cost (6.3% higher; 95% CI: 5.6%-7.1%; P < 0.001) compared to those without it.

Original languageEnglish (US)
Pages (from-to)1363-1371
Number of pages9
JournalSpine
Volume43
Issue number19
DOIs
StatePublished - Oct 1 2018

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Psychiatry
Comorbidity
Confidence Intervals
Odds Ratio
Acute Kidney Injury
Length of Stay
Hospitalization
Costs and Cost Analysis
Intervertebral disc disease
Venous Thromboembolism
Wound Infection
Nervous System
Observational Studies
Inpatients
Mental Health
Spine
Cohort Studies
Referral and Consultation
Regression Analysis
Demography

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Clinical Neurology

Cite this

Impact of Psychiatric Comorbidities on Short-Term Outcomes Following Intervention for Lumbar Degenerative Disc Disease. / Kalakoti, Piyush; Sciubba, Daniel; Pugely, Andrew J.; McGirt, Matthew J.; Sharma, Kanika; Patra, Devi P.; Phan, Kevin; Madhavan, Karthik; Menger, Richard P.; Notarianni, Christina; Guthikonda, Bharat; Nanda, Anil; Sun, Hai.

In: Spine, Vol. 43, No. 19, 01.10.2018, p. 1363-1371.

Research output: Contribution to journalArticle

Kalakoti, P, Sciubba, D, Pugely, AJ, McGirt, MJ, Sharma, K, Patra, DP, Phan, K, Madhavan, K, Menger, RP, Notarianni, C, Guthikonda, B, Nanda, A & Sun, H 2018, 'Impact of Psychiatric Comorbidities on Short-Term Outcomes Following Intervention for Lumbar Degenerative Disc Disease', Spine, vol. 43, no. 19, pp. 1363-1371. https://doi.org/10.1097/BRS.0000000000002616
Kalakoti, Piyush ; Sciubba, Daniel ; Pugely, Andrew J. ; McGirt, Matthew J. ; Sharma, Kanika ; Patra, Devi P. ; Phan, Kevin ; Madhavan, Karthik ; Menger, Richard P. ; Notarianni, Christina ; Guthikonda, Bharat ; Nanda, Anil ; Sun, Hai. / Impact of Psychiatric Comorbidities on Short-Term Outcomes Following Intervention for Lumbar Degenerative Disc Disease. In: Spine. 2018 ; Vol. 43, No. 19. pp. 1363-1371.
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abstract = "CONCLUSION: Our study quantifies the estimates for presence of concomitant psychiatric comorbid conditions on short outcomes in patients undergoing fusions for LDDD. The data provide supporting evidence for adequate preoperative planning and postsurgical care including consultation for mental health for favorable outcomes.4.STUDY DESIGN: Retrospective, observational cohort study.OBJECTIVE: To investigate the impact of psychiatric diseases on short-term outcomes in patients undergoing fusion surgery for lumbar degenerative disc disease (LDDD).SUMMARY OF BACKGROUND DATA: Limited literature exists on the prevalence and impact of psychiatric comorbidities on outcomes in patients undergoing surgery for LDDD.METHODS: Adult patients (>18 yr) registered in the Nationwide Inpatient Sample database (2002-2011) and undergoing an elective spine fusion for LDDD that met inclusion criteria formed the study population. Defined primary outcome measures were discharge disposition, length of stay, hospitalization cost, and short-term postsurgical complications (neurological, respiratory, cardiac, gastrointestinal, wound complication and infections, venous thromboembolism, and acute renal failure). Multivariable regression techniques were used to explore the association of psychiatric comorbidities on short-term outcomes by adjusting for patient demographics, clinical, and hospital characteristics.RESULTS: Of the 126,044 adult patients undergoing fusion surgery for LDDD (mean age: 54.91 yr, 58{\%} female) approximately 18{\%} had a psychiatric disease. Multivariable regression analysis revealed patients with psychiatric disease undergoing fusion surgery have higher likelihood for unfavorable discharge (odds ratio [OR] 1.41; 95{\%} confidence interval [CI] 1.35-1.47; P < 0.001), length of stay (OR 1.03; 95{\%} CI 1.02-1.04; P < 0001), postsurgery neurologic complications (OR 1.25; 95{\%} CI 1.13-1.37; P < 0.001), venous thromboembolic events (OR 1.38 95{\%} CI 1.26-1.52; P < 0.001), and acute renal failure (OR 1.17; 95{\%} CI 1.01-1.37; P = 0.040). Patients with psychiatric disease were also associated to have higher hospitalization cost (6.3{\%} higher; 95{\%} CI: 5.6{\%}-7.1{\%}; P < 0.001) compared to those without it.",
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T1 - Impact of Psychiatric Comorbidities on Short-Term Outcomes Following Intervention for Lumbar Degenerative Disc Disease

AU - Kalakoti, Piyush

AU - Sciubba, Daniel

AU - Pugely, Andrew J.

AU - McGirt, Matthew J.

AU - Sharma, Kanika

AU - Patra, Devi P.

AU - Phan, Kevin

AU - Madhavan, Karthik

AU - Menger, Richard P.

AU - Notarianni, Christina

AU - Guthikonda, Bharat

AU - Nanda, Anil

AU - Sun, Hai

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N2 - CONCLUSION: Our study quantifies the estimates for presence of concomitant psychiatric comorbid conditions on short outcomes in patients undergoing fusions for LDDD. The data provide supporting evidence for adequate preoperative planning and postsurgical care including consultation for mental health for favorable outcomes.4.STUDY DESIGN: Retrospective, observational cohort study.OBJECTIVE: To investigate the impact of psychiatric diseases on short-term outcomes in patients undergoing fusion surgery for lumbar degenerative disc disease (LDDD).SUMMARY OF BACKGROUND DATA: Limited literature exists on the prevalence and impact of psychiatric comorbidities on outcomes in patients undergoing surgery for LDDD.METHODS: Adult patients (>18 yr) registered in the Nationwide Inpatient Sample database (2002-2011) and undergoing an elective spine fusion for LDDD that met inclusion criteria formed the study population. Defined primary outcome measures were discharge disposition, length of stay, hospitalization cost, and short-term postsurgical complications (neurological, respiratory, cardiac, gastrointestinal, wound complication and infections, venous thromboembolism, and acute renal failure). Multivariable regression techniques were used to explore the association of psychiatric comorbidities on short-term outcomes by adjusting for patient demographics, clinical, and hospital characteristics.RESULTS: Of the 126,044 adult patients undergoing fusion surgery for LDDD (mean age: 54.91 yr, 58% female) approximately 18% had a psychiatric disease. Multivariable regression analysis revealed patients with psychiatric disease undergoing fusion surgery have higher likelihood for unfavorable discharge (odds ratio [OR] 1.41; 95% confidence interval [CI] 1.35-1.47; P < 0.001), length of stay (OR 1.03; 95% CI 1.02-1.04; P < 0001), postsurgery neurologic complications (OR 1.25; 95% CI 1.13-1.37; P < 0.001), venous thromboembolic events (OR 1.38 95% CI 1.26-1.52; P < 0.001), and acute renal failure (OR 1.17; 95% CI 1.01-1.37; P = 0.040). Patients with psychiatric disease were also associated to have higher hospitalization cost (6.3% higher; 95% CI: 5.6%-7.1%; P < 0.001) compared to those without it.

AB - CONCLUSION: Our study quantifies the estimates for presence of concomitant psychiatric comorbid conditions on short outcomes in patients undergoing fusions for LDDD. The data provide supporting evidence for adequate preoperative planning and postsurgical care including consultation for mental health for favorable outcomes.4.STUDY DESIGN: Retrospective, observational cohort study.OBJECTIVE: To investigate the impact of psychiatric diseases on short-term outcomes in patients undergoing fusion surgery for lumbar degenerative disc disease (LDDD).SUMMARY OF BACKGROUND DATA: Limited literature exists on the prevalence and impact of psychiatric comorbidities on outcomes in patients undergoing surgery for LDDD.METHODS: Adult patients (>18 yr) registered in the Nationwide Inpatient Sample database (2002-2011) and undergoing an elective spine fusion for LDDD that met inclusion criteria formed the study population. Defined primary outcome measures were discharge disposition, length of stay, hospitalization cost, and short-term postsurgical complications (neurological, respiratory, cardiac, gastrointestinal, wound complication and infections, venous thromboembolism, and acute renal failure). Multivariable regression techniques were used to explore the association of psychiatric comorbidities on short-term outcomes by adjusting for patient demographics, clinical, and hospital characteristics.RESULTS: Of the 126,044 adult patients undergoing fusion surgery for LDDD (mean age: 54.91 yr, 58% female) approximately 18% had a psychiatric disease. Multivariable regression analysis revealed patients with psychiatric disease undergoing fusion surgery have higher likelihood for unfavorable discharge (odds ratio [OR] 1.41; 95% confidence interval [CI] 1.35-1.47; P < 0.001), length of stay (OR 1.03; 95% CI 1.02-1.04; P < 0001), postsurgery neurologic complications (OR 1.25; 95% CI 1.13-1.37; P < 0.001), venous thromboembolic events (OR 1.38 95% CI 1.26-1.52; P < 0.001), and acute renal failure (OR 1.17; 95% CI 1.01-1.37; P = 0.040). Patients with psychiatric disease were also associated to have higher hospitalization cost (6.3% higher; 95% CI: 5.6%-7.1%; P < 0.001) compared to those without it.

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