Incidence and Risk Factors for New-onset Depression After Total Shoulder Arthroplasty

Area of Science:

• Orthopedic Surgery
• Psychiatry
• Health Outcomes Research

Background:

• New-onset depression (NOD) is an emerging concern following total shoulder arthroplasty (TSA).
• NOD significantly impacts patient recovery and overall outcomes after TSA.
• Understanding the incidence and predictors of NOD is crucial for improving patient care.

Purpose of the Study:

• To determine the incidence of NOD within one year after TSA.
• To identify risk factors and postoperative complications associated with NOD.
• To evaluate the impact of NOD on revision surgery rates within five years.

Main Methods:

• A retrospective analysis of the PearlDiver Mariner database (2010-2022) included adult patients undergoing primary TSA.
• Exclusion criteria focused on pre-existing conditions like tumors, trauma, infections, and prior psychiatric history.
• Patients with and without NOD were matched and compared for 90-day complications and 5-year revision rates using statistical analysis.

Main Results:

• Out of 144,773 TSA patients, 3.0% (4,321) were diagnosed with NOD within a year.
• NOD was more prevalent in females and those with a higher comorbidity burden.
• Patients with NOD exhibited increased odds of 90-day complications, emergency visits, readmissions, and 5-year revision TSA.

Conclusions:

• Postoperative NOD affects 3% of patients undergoing TSA.
• NOD is significantly associated with adverse postoperative outcomes, including complications and higher revision rates.
• Identifying patients at risk for NOD can guide targeted interventions to mitigate negative consequences.