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Increased In-Hospital Lengths of Stay, Readmission Rates, Complications, and Costs in Patients Who Have Depressive

William M DeGouveia1, Hytham S Salem2, Zhongming Chen2

  • 1Department of Orthopaedic Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York.

Surgical Technology International
|January 28, 2022
PubMed

Insights

Patients with depressive disorders undergoing total hip arthroplasty (THA) experience longer hospital stays and higher rates of medical and implant complications. This highlights the need for enhanced patient counseling and care strategies for this population.

Area of Science:

  • Orthopedic Surgery
  • Psychiatry
  • Health Services Research

Background:

  • Increasing prevalence of depressive disorders in the US.
  • Limited research on the impact of depression on primary total hip arthroplasty (THA) outcomes.
  • Need to understand the risks associated with THA in patients with depressive disorders.

Purpose of the Study:

  • To determine if patients with depressive disorders have increased in-hospital length of stay (LOS) after primary THA.
  • To assess if depressive disorders are associated with higher readmission rates post-THA.
  • To investigate the impact of depressive disorders on medical and implant-related complications following THA.

Main Methods:

  • Retrospective analysis of the Humana claims database.
  • Identification of primary THA patients with and without depressive disorders using ICD-9 and CPT codes.
  • Matching of study and control groups (1:5) by age, sex, and comorbidities; statistical analysis using Welch's t-tests and logistic regression.

Main Results:

  • Patients with depressive disorders had significantly longer in-hospital LOS (6.59 vs. 2.96 days).
  • Higher incidence of readmission rates (46.02% vs. 35.43%) in patients with depressive disorders.
  • Increased odds of medical (OR: 4.04) and implant-related complications (OR: 2.16) in the depressive disorders cohort.

Conclusions:

  • Depressive disorders are associated with significantly longer LOS and increased complication and readmission rates after primary THA.
  • Findings underscore the importance of pre-operative counseling for orthopedic surgeons regarding potential risks for patients with depression.
  • This research provides critical data for optimizing care pathways for THA patients with depressive disorders.
Abstract

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