P133. Impact of depression on short-term outcomes following anterior cervical discectomy and fusion

Abstract

BACKGROUND CONTEXT The increased prevalence of depression in patients suffering chronic pain, including neck and back pain, is well documented. Previous research has reported that a preoperative diagnosis of depression is associated with increased rates of complications, revision surgery and opioid use after spinal surgery. PURPOSE This study aims to compare rates of perioperative complications, hospital charges, and length of stay (LOS) following anterior cervical discectomy and fusion (ACDF) in patients with and without a preoperative diagnosis of depression. STUDY DESIGN/SETTING Retrospective cohort study. PATIENT SAMPLE A total of 292,009 patients underwent elective ACDF, with 28,918 patients (9.9%) having a preoperative diagnosis of depression. The average age for the depression and non-depression groups were 53.54 and 53.30 years, respectively. Patients under the age of 18 years were excluded. OUTCOME MEASURES This study compared perioperative complication rates, hospital costs and length of stay (LOS) following ACDF between the groups. METHODS A total of 35 million hospital discharges between 2010 to 2014 were screened using the National Inpatient Sample (NIS). The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis and procedure codes were used to identify patients who underwent ACDF, as well as patients with a preoperative diagnosis of depression. Perioperative complications were identified using ICD-9-CM diagnosis codes. Logistic regression analyses were performed to compare complication rates between the two groups. The Kruskal Wallis H test was used to calculate and compare mean LOS and hospital charges. RESULTS Complication rates were higher in patients without depression compared to patients with depression (3.09% vs 2.54%, p CONCLUSIONS Patients with a preoperative diagnosis of depression had lower rates of perioperative complications and shorter LOS following ACDF compared to patients without a diagnosis of depression. While our findings contrast previous investigations of the role of depression in orthopedic surgery outcomes, our findings add to a small but growing body of literature reporting decreased rates of perioperative complications in patients with depression. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.