Depression and Anxiety Associated with Complications after Foot and Ankle Surgery in Diabetic Patients—Comparison with a Nondiabetic Population

Abstract

The purpose of this study is to evaluate and compare the complications rates in diabetic patients with a history of depression and anxiety than those without diabetes following foot and ankle surgery. Diabetes and a diagnosis of depression have shown to increase post-surgical complication rates in other specialities including cardiothoracic surgery and plastic surgery. 1patients who were surgically treated by one surgeon at one hospital with foot and ankle conditions were retrospectively reviewed, identifying 28 patients with diabetes, 14 diabetic patients with depression, 1 with anxiety and 2 with both depression and anxiety. In comparison, there were 78 patients without diabetes identified and of those 78 subjects, 22 had depression, 3 with anxiety and 9 with both depression and anxiety. The primary outcomes evaluated were the rates of post-surgical complications and glycemic control. Diabetes, depression and anxiety was confirmed by diagnosis history and treatment. Most common complications included superficial soft tissue infection (SSI) and incisional dehiscence/delayed healing. Diabetic patients with a history of depression and anxiety had a 1.8 times higher likelihood to develop a post-surgical complication. Patients with diabetes with a history of a psychological disorder showed a complication rate of 28%. The complication rate associated with a psychological disorder without diabetes was 15%. In the 1patients, a psychological disorder was noted in 60% of the diabetic patient cases and for the group without diabetes was noted to be 43.5%. The mean HgbA1c of the 28 diabetic patients without complications included a mean of 6.5. The presence of depression and anxiety in a diabetic patient negatively impacts the outcomes of patients undergoing foot and ankle surgery resulting in a higher likelihood of post-surgical complications in compared to those without diabetes. Disclosure K. Kirby: None. K. Hobizal: None. R. Shepherd: None. T. Wize: None.