Relationship Among Koenig Depression Scale and Postoperative Outcomes, Ambulation, and Perception of Pain in Elderly Patients (≥65 Years) Undergoing Elective Spinal Surgery for Adult Scoliosis.

Abstract

The aim of this study was to assess whether the Koenig Depression Scale (KDS) can identify depressed elderly patients undergoing elective spine surgery for deformity at risk for inferior postoperative outcomes including complication rates, ambulation ability, and patient-reported outcomes. The medical records of 92 elderly patients (≥65 years) undergoing a planned elective spinal surgery for correction of adult degenerative scoliosis were reviewed for this study. Preoperative baseline depression was assessed using the validated KDS that was administered by a board-certified geriatrician. KDS is made up of 11 questions with a maximum of 11 points (No-Depression= KDS <4, Depression= KDS ≥4). The primary outcomes of this study were complication rates, duration of hospital stay, ambulation ability, and follow-up visual analog scale (VAS) scores at 6 weeks, 3 months, and 6 months after hospital discharge. Of the 92 patients, 20 of them (21.7%) were found to have a KDS ≥4. Baseline demographics and comorbidities were similar between both cohorts. Intraoperative variables and complications were similar between both cohorts. There were no significant differences in postoperative complications including length of hospital stay. There was no significant difference in ambulation abilities including preoperative gait speed (P= 0.38), days from operation to ambulation (P= 0.86), steps on first day of ambulation (P= 0.57), and steps before hospital discharge (P= 0.35). There was no significant difference between the cohorts in VAS scores at baseline (P= 0.19), 6 weeks (P= 0.91), 3 months (P= 0.58), and 6 months (P= 0.97) after hospital discharge. Our study found no difference in complication rates, ambulation abilities, and follow-up VAS scores between patients with and without depression using preoperative KDS.