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首页> 外文期刊>Psychosomatics >Demographics and Perioperative Outcome in Patients with Depression and Anxiety Undergoing Total Joint Arthroplasty: A Population-Based Study
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Demographics and Perioperative Outcome in Patients with Depression and Anxiety Undergoing Total Joint Arthroplasty: A Population-Based Study

机译：进行全关节置换术的抑郁症和焦虑症患者的人口统计学和围手术期结果：一项基于人群的研究

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Background: Depression and anxiety are highly prevalent psychiatric disorders. However, little is known about their impact on outcomes in the perioperative setting. This study is intended to gain insight into epidemiology and effects on perioperative morbidity, mortality, length of hospital stay, discharge and cost. Methods: We obtained the National Inpatient Sample from the Hospital Cost and Utilization Project for each year between 2000 and 2008. Entries indicating the performance of primary total hip and knee arthroplasty were identified and separated into four groups: (1) those with concomitant diagnosis of depression or (2) anxiety, (3) both, and (4) none of these diagnoses. The incidence of major complications, non-routine discharge, length, and cost of hospitalization were assessed. Regression analysis was performed to identify if psychiatric comorbidity was an independent risk factor for each outcome. Results: We identified 1,212,493 patients undergoing arthroplasty between 2000 and 2008. The prevalence of depression and anxiety significantly increased over time. Patients with either condition had higher hospital charges, rates of non-routine discharges and comorbidity index. Depression or anxiety were associated with significantly decreased adjusted odds for in-hospital mortality (OR = 0.53, p = 0.0147; OR = 0.58, p = 0.0064). The risk of developing a major complication was slightly lower in patients with depression, anxiety or both (OR=0.95, p = 0.0738; OR = 0.95, p = 0.0259; OR = 0.94, p = 0.7349). Conclusions: Patients suffering from depression, anxiety, or both require more healthcare resources in a perioperative setting. However, lower short-term mortality in spite of higher comorbidity burden and without extensive changes in perioperative complication profile indicates better outcome for this group of patients.
机译：背景：抑郁和焦虑症是高度流行的精神病。但是，关于它们对围手术期结局的影响知之甚少。本研究旨在深入了解流行病学及其对围手术期发病率，死亡率，住院时间，出院和费用的影响。方法：我们从2000年至2008年之间，每年从“医院费用和利用项目”中获得“全国住院患者样本”。对表明初次全髋和膝关节置换术表现的条目进行了鉴定，并将其分为四组：（1）合并诊断为抑郁症或（2）焦虑症，（3）两者都有，以及（4）这些诊断均无。评估主要并发症，非常规出院，病程和住院费用的发生率。进行回归分析以确定精神病合并症是否是每个结局的独立危险因素。结果：我们确定了2000年至2008年之间接受关节置换术的1,212,493例患者。抑郁和焦虑症的患病率随时间显着增加。有这两种情况的患者都有较高的住院费用，非常规出院率和合并症指数。抑郁或焦虑与院内死亡率调整后的机率明显降低有关（OR = 0.53，p = 0.0147; OR = 0.58，p = 0.0064）。患有抑郁症，焦虑症或两者兼有的患者发生重大并发症的风险略低（OR = 0.95，p = 0.0738; OR = 0.95，p = 0.0259; OR = 0.94，p = 0.7349）。结论：患有抑郁症，焦虑症或两者兼有的患者在围手术期需要更多的医疗资源。然而，尽管合并症负担增加，但围手术期并发症没有广泛变化，但短期死亡率却较低，这表明该组患者的预后较好。

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