Examining the Influence of Psychiatric Comorbidities on Postoperative Outcomes in Total Ankle Arthroplasty

IntroductionThis study aims to evaluate the effect of mental health disorders on the postoperative outcomes of patients undergoing primary total ankle arthroplasty (TAA).MethodsThe Nationwide Readmissions Database was queried to identify 29 705 patients undergoing primary TAA from 2015 to 2020. Patients were divided into cohorts based on concurrent mental health disorder (MHD) (MHD = 6041, no MHD = 23,664), with sub-analysis for depression, anxiety, psychosis, bipolar disorder, and posttraumatic stress disorder.ResultsPatients with any MHD were significantly younger (P < .001), more likely to be female (P < .001), lower income (P < .001), and had a higher Charlson-Deyo comorbidity index (P < .001). Multivariate regression analysis found any MHD to be predictive of increased risk of any complication (odds ratio [OR] = 1.108; 95% confidence interval [CI] = 1.001-1.227; P = .048), adverse discharge (OR = 1.552; 95% CI =1.450-1.660; P < .001), extended stay (OR = 1.339; 95% CI = 1.204-1.488; P < .001), and infection (OR = 1.762; 95% CI = 1.305-2.377; P < .001).ConclusionPatients with MHD are at a statistically significantly higher risk of complications, infections, protracted hospital stays, and adverse discharge outcomes following primary TAA.Level of Evidence:Level III, retrospective comparative database study.