Exploring the Relationship Between Surgical Outcomes and Psychiatric Disorders: A Database Mining Study on...

Area of Science:

• Medical research
• Psychiatry
• Health services research

Background:

• Postoperative depression and anxiety are significant concerns following surgical procedures.
• Understanding their frequency, risk factors, and healthcare implications is crucial for patient care.
• Population-scale data can provide comprehensive insights into these perioperative psychiatric outcomes.

Purpose of the Study:

• To quantify the incidence of postoperative depression and anxiety using population-scale administrative data.
• To identify key risk factors associated with these psychiatric disorders after surgery.
• To evaluate the impact of postoperative psychiatric disorders on healthcare utilization and costs.

Main Methods:

• Retrospective cohort analysis of the U.S. Healthcare Cost and Utilization Project National Inpatient Sample (HCUP-NIS) database (2016-2022).
• Inclusion of 4.2 million surgical procedures across 47 states.
• Identification of postoperative psychiatric disorders using ICD-10 codes (F32.x, F41.x) within 30 days post-surgery.
• Application of multivariable logistic regression and propensity score matching to assess risk factors and healthcare utilization disparities.

Main Results:

• The overall frequency of newly diagnosed postoperative psychiatric disorders was 14.3% (depression 9.1%, anxiety 8.7%).
• Hip fracture surgery (aOR 2.34), thoracotomy (aOR 1.89), and cardiac procedures (aOR 1.67) showed significantly higher risks.
• Associated risk factors included female sex (aOR 1.43), age >65 years (aOR 1.28), and operative duration >5 hours (aOR 1.52).
• Propensity-matched analysis indicated prolonged hospitalization (13.2 vs 8.4 days), higher 30-day readmission rates (28.9% vs 19.6%), and increased total costs ($47,680 vs $31,250) for patients with psychiatric disorders.

Conclusions:

• Significant heterogeneity exists in postoperative psychiatric disorder risk across surgical specialties.
• Postoperative depression and anxiety substantially increase healthcare utilization and costs.
• Systematic psychiatric screening and targeted perioperative interventions are recommended for high-risk surgical populations.