腰椎融合后的新发精神疾病:预测因素,时间和风险分层
Alexander M Ballatori1, Shane Shahrestani2, Andy Ton3
1Department of Orthopaedic Surgery, University of Southern California, Los Angeles, CA, USA.
Global spine journal
|November 17, 2025
概括
腰部融合手术后,抑郁症和焦虑症等新的精神疾病很常见,通常在90天内出现. 外科期间使用阿片类药物和社会经济因素增加了这种风险,强调了早期心理健康查的必要性.
科学领域:
- 神经外科 神经外科
- 精神病学是一个精神病学.
- 医疗保健服务研究 医疗服务研究
背景情况:
- 腰椎融合手术是脊柱疾病的常见手术.
- 手术后的并发症会对患者的康复和生活质量产生重大影响.
研究的目的:
- 确定腰部融合后新发精神疾病的发生率,时间和预测因素.
- 开发一种风险分层模型,用于早期识别有风险的患者.
主要方法:
- 使用全国再接收数据库 (2016-2019) 进行回顾性队列研究.
- 包括接受选择性住院腰部融合的成年患者,但不包括先前有精神病诊断的患者.
- 在手术后12个月内对新出现的抑郁,焦虑,自杀念头和杀人念头进行分析.
主要成果:
- 超过839,000名患者,12,011人患有抑郁症,11,828人患有焦虑症.
- 大多数精神病诊断发生在90天内,在手术后3周左右达到顶峰.
- 阿片类药物使用和医疗补助保险是精神疾病,特别是自杀念头的重要预测因素.
结论:
- 新发病的精神疾病是腰部融合后常见的早期并发症.
- 可修改的因素,如外科手术期间使用阿片类药物和人口因素,如社会经济地位预测风险.
- 结构化的心理健康查和风险分层对于早期干预和改善患者结果至关重要.
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