94. Affective disorders are associated with longer hospitalization and hospital charges in patients undergoing elective lumbar spinal fusion

Abstract

BACKGROUND CONTEXT Affective disorders, including depression and anxiety disorders, are becoming more prevalent among the general population and patients. PURPOSE The objective of this study was to examine the association between affective disorders and outcome measures in patients undergoing elective lumbar spinal fusion. STUDY DESIGN/SETTING A retrospective cohort study was conducted using the National Inpatient Sample database. PATIENT SAMPLE Patients who underwent lumbar fusions between 2011-2018. OUTCOME MEASURES Hospital charges, length of hospital stay, postoperatrive compliations. METHODS Patients were stratified into two groups: (1) with affective disorder and (2) without affective disorder. Propensity score matching was utilized to minimize effect of confounding variables. RESULTS A total of 255,875 cases of lumbar fusions met inclusion criteria. A total of 25,843 (10.1%) patients carried the diagnosis of affective disorder and were significantly more likely to be non-White (45.1% vs 19.9%) and of older age group (59.2 vs 49.9 years) as compared to patients without affective disorders. Patients with affective disorder had longer hospital stay (6.1 vs 3.1 days) as well as increased hospital charges ($88,819 vs $78,650), (P <0.001). No difference was observed in the rates of postoperative complications or short-term mortality between the two groups. CONCLUSIONS Our study found that affective disorders were significantly associated with increased length of hospital stay as well as increased total hospital charges in patients undergoing elective lumbar spinal fusion. Future studies are encouraged to further investigate the feasibility of perioperative screening and for affective disorders and addressing them accordingly. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs. Affective disorders, including depression and anxiety disorders, are becoming more prevalent among the general population and patients. The objective of this study was to examine the association between affective disorders and outcome measures in patients undergoing elective lumbar spinal fusion. A retrospective cohort study was conducted using the National Inpatient Sample database. Patients who underwent lumbar fusions between 2011-2018. Hospital charges, length of hospital stay, postoperatrive compliations. Patients were stratified into two groups: (1) with affective disorder and (2) without affective disorder. Propensity score matching was utilized to minimize effect of confounding variables. A total of 255,875 cases of lumbar fusions met inclusion criteria. A total of 25,843 (10.1%) patients carried the diagnosis of affective disorder and were significantly more likely to be non-White (45.1% vs 19.9%) and of older age group (59.2 vs 49.9 years) as compared to patients without affective disorders. Patients with affective disorder had longer hospital stay (6.1 vs 3.1 days) as well as increased hospital charges ($88,819 vs $78,650), (P <0.001). No difference was observed in the rates of postoperative complications or short-term mortality between the two groups. Our study found that affective disorders were significantly associated with increased length of hospital stay as well as increased total hospital charges in patients undergoing elective lumbar spinal fusion. Future studies are encouraged to further investigate the feasibility of perioperative screening and for affective disorders and addressing them accordingly.