Thursday, September 27, 2018 1:05 PM–2:05 PM Understanding Anxiety and Depression when Performing Spine Surgery: 117. Psychiatric diagnosis impacts outcomes in surgical treatment of cervical myelopathy

Abstract

BACKGROUND CONTEXT Cervical myelopathy is a common disorder of the spine caused by numerous disease processes and is often treated surgically. Psychiatric diagnoses are known to impact outcomes of surgical procedures; however, the impact of psychiatric disorders on postoperative outcomes for the diagnosis of cervical myelopathy is not well understood. PURPOSE The purpose of this study was to assess the impact of psychiatric comorbidities on postoperative outcomes in patients undergoing surgical treatment for cervical myelopathy. STUDY DESIGN/SETTING This was a retrospective cohort analysis performed on a national database using a 20% stratified sample of discharges from United States hospitals. This database did not include rehabilitation and long-term acute care facilities and is the largest publicly available inpatient, all-payer database in the U.S. PATIENT SAMPLE The Healthcare Cost and Utilization Project National Inpatient Sample database 2013-2014 was queried for hospitalizations with a diagnosis of cervical myelopathy based on International Classification of Diseases ninth revision clinical modification (ICD-9-CM) code 721.1. The analysis included only those undergoing a procedure. OUTCOME MEASURES Primary outcomes queried were relevant complications listed in the NIS, overall complication rate, discharge disposition, length of stay, mortality and total hospital charges. METHODS Descriptive statistics were used to characterize cases with psychiatric comorbidities versus those without. Demographic data was compared using Chi-square and Student's t-test and multivariate analysis was used to identify the impact of a psychiatric diagnosis for various outcomes. RESULTS A total of 24,142 hospitalizations met the inclusion criteria. Of these, 1,002 (4.2%) had a diagnosed psychiatric disorder. Hospitalizations with a psychiatric comorbidity tended to be younger (58.9 vs. 62.0, p CONCLUSIONS Patients with psychiatric comorbidities undergoing surgical treatment for cervical myelopathy have an increased risk of nonhome discharge, a longer length of hospital stay, but no increased risk of postoperative complications or mortality, nor any significant difference in total hospital charges. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.