Thursday, September 27, 2018 1:05 PM–2:05 PM Understanding Anxiety and Depression when Performing Spine Surgery: 119. Impact of psychiatric comorbidities on short-term outcomes following intervention for lumbar degenerative disc disease

Abstract

BACKGROUND CONTEXT Limited literature exists on the prevalence and impact of psychiatric comorbidities on outcomes in patients undergoing surgery for with lumbar degenerative disc disease (LDDD). PURPOSE To investigate the impact of psychiatric diseases on short-term outcomes in patients undergoing fusion surgery for LDDD. STUDY DESIGN/SETTING Retrospective, observational cohort study. PATIENT SAMPLE A total of 126,044 adult patients (>18 years) registered in the Nationwide Inpatient Sample database (2002-2011) and undergoing an elective spine fusion for LDDD. OUTCOME MEASURES Discharge to rehabilitation facility, length of stay, hospitalization cost, and short-term postsurgical complications (neurological, respiratory, cardiac, gastro-intestinal, wound complication and infections, venous thromboembolism, and acute-renal failure). METHODS Multivariable regression techniques were used to explore the association of psychiatric comorbidities on short-term outcomes by adjusting for patient demographics, clinical and hospital characteristics. As a part of sensitivity analysis, propensity scores matching methods and inverse weighting technique was utilized. RESULTS Of the 126,044 adult patients undergoing fusion surgery for LDDD (mean age: 54.91 years, 58% female), approximately 18% had a psychiatric disease. Multivariable regression analysis revealed patients with psychiatric disease undergoing fusion surgery have higher likelihood for unfavorable discharge (OR 1.41; 95%CI 1.35–1.47; p CONCLUSIONS Our study quantifies the estimates for presence of concomitant psychiatric comorbid conditions on short-outcomes in patients undergoing fusions for LDDD. The data provides supporting evidence for adequate preoperative planning and postsurgical care. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.