Scholarlink

Purpose <p>Mental health disorders have been shown to influence surgical outcomes, yet their effects on cervical spine surgery remain incompletely defined. This study evaluated the impact of depression and psychotic disorders on (1) perioperative complications, (2) discharge disposition, and (3) hospital resource utilization following anterior cervical discectomy and fusion (ACDF).</p> Methods <p>The National Inpatient Sample (NIS) was queried for adult ACDF admissions from 2016 to 2022. Patients were classified into those with either no mental illness, depression, or psychotic disorder. Medical/surgical complications, dysphagia, and overall adverse events were extracted using ICD-10 diagnosis codes. Discharge status, inpatient mortality, costs, and length of stay were also evaluated across all cohorts. Subsequent analyses were adjusted for demographics, Elixhauser comorbidity index, hospital characteristics, and levels fused. Fusion level was included as a categorical covariate (single-level vs. multilevel) in all adjusted regression models. Multivariable logistic regression estimated adjusted odds ratios for complications/discharge outcomes, while weighted linear models compared/contrasted healthcare utilization with statistical significance set at <i>P</i> &lt; 0.05.</p> Results <p>376,130 inpatient ACDFs were identified (64,020 with depression, 11,255 with psychotic disorders). Depression was associated with increased cardiovascular complications (OR 1.28, 95% CI 1.16–1.41), dysphagia (OR 1.09, 95% CI 1.02–1.18), and non-routine discharge (OR 1.15, 95% CI 1.09–1.21). Psychotic disorders were associated with increased rates of cardiovascular events (OR 1.29, 95% CI 1.04–1.59), mechanical complications (OR 1.36, 95% CI 1.01–1.83), and non-routine discharge (OR 1.47, 95% CI 1.32–1.64). Both mean costs and length of stay were likewise higher in patients with mental disorders (<i>P</i> &lt; 0.001).</p> Conclusion <p>Mental health disorders are associated with increased postoperative complications, non-routine discharge, and healthcare utilization following ACDF. Appropriate diagnosis, management, and preoperative optimization may improve outcomes in this patient population.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Impact of mental health disorders and perioperative outcomes following anterior cervical discectomy and fusion (ACDF): a national inpatient analysis

  • 期刊论文

  • 发表日期：

    2026年1月20日

查看全文
  • Mitchell Ng,
  • Leonidas Mastrokostas,
  • Paul Mastrokostas,
  • Gregorio Baek,
  • Jonathan Dalton,
  • Adam Fano,
  • Alec Giakas,
  • Rajendra Singh,
  • Afshin Razi,
  • Arya Varthi,
  • Mark Kurd,
  • Zachary Wilt,
  • Daniel Fassett,
  • Alan Hilibrand,
  • Alexander Vaccaro,
  • Gregory Schroeder,
  • Christopher Kepler,
  • Andrew Alvarez

摘要

Purpose

Mental health disorders have been shown to influence surgical outcomes, yet their effects on cervical spine surgery remain incompletely defined. This study evaluated the impact of depression and psychotic disorders on (1) perioperative complications, (2) discharge disposition, and (3) hospital resource utilization following anterior cervical discectomy and fusion (ACDF).

Methods

The National Inpatient Sample (NIS) was queried for adult ACDF admissions from 2016 to 2022. Patients were classified into those with either no mental illness, depression, or psychotic disorder. Medical/surgical complications, dysphagia, and overall adverse events were extracted using ICD-10 diagnosis codes. Discharge status, inpatient mortality, costs, and length of stay were also evaluated across all cohorts. Subsequent analyses were adjusted for demographics, Elixhauser comorbidity index, hospital characteristics, and levels fused. Fusion level was included as a categorical covariate (single-level vs. multilevel) in all adjusted regression models. Multivariable logistic regression estimated adjusted odds ratios for complications/discharge outcomes, while weighted linear models compared/contrasted healthcare utilization with statistical significance set at P < 0.05.

Results

376,130 inpatient ACDFs were identified (64,020 with depression, 11,255 with psychotic disorders). Depression was associated with increased cardiovascular complications (OR 1.28, 95% CI 1.16–1.41), dysphagia (OR 1.09, 95% CI 1.02–1.18), and non-routine discharge (OR 1.15, 95% CI 1.09–1.21). Psychotic disorders were associated with increased rates of cardiovascular events (OR 1.29, 95% CI 1.04–1.59), mechanical complications (OR 1.36, 95% CI 1.01–1.83), and non-routine discharge (OR 1.47, 95% CI 1.32–1.64). Both mean costs and length of stay were likewise higher in patients with mental disorders (P < 0.001).

Conclusion

Mental health disorders are associated with increased postoperative complications, non-routine discharge, and healthcare utilization following ACDF. Appropriate diagnosis, management, and preoperative optimization may improve outcomes in this patient population.