Examining the relationship between severe persistent mental illness and surgical outcomes in women undergoing mastectomy for breast cancer

Abstract

BackgroundSevere persistent mental illness (SPMI) is associated with worse outcomes in cancer patients. Less is known about the relationship between SPMI and surgical outcomes after mastectomy for breast cancer. MethodsWe selected patients with breast cancer and SPMI from the National Inpatient Sample (2016–2018) and used propensity score matching. We then used multivariate analysis, Kruskal-Wallis tests, and conditional logistic regression to compare demographics and outcomes. ResultsThe study sample consisted of 670 patients: 536 without SPMI and 134 with SPMI. SPMI was associated with bilateral mastectomy (bilateral: 53% vs. unilateral: 42.7%, p = 0.033) and decreased frequency of breast reconstruction (p < 0.001). SPMI was associated with more extended hospitalization (4 days vs. 2 days, p < 0.001) and increased risk of developing post-procedural infection and sepsis (OR 2.909). ConclusionsSPMI is associated with bilateral mastectomy, more extended hospitalization, and increased risk for post-procedural infection and sepsis – suggesting the need for increased use of standardized screening tools to identify SPMI in patients and inform perioperative management correctly.