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首页> 外文期刊>Journal of shoulder and elbow surgery >The influence of psychiatric comorbidity on perioperative outcomes after shoulder arthroplasty
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The influence of psychiatric comorbidity on perioperative outcomes after shoulder arthroplasty

机译：精神病合并症对肩关节置换术后围手术期结局的影响

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Background: Psychiatric comorbidity has been associated with increased health risks and poor long-term treatment outcomes in numerous medical disciplines, but its effect in short-term perioperative settings is incompletely understood. The purpose of this study was to evaluate the influence of a preoperative diagnosis of depressive disorder, anxiety disorder, schizophrenia, or dementia on in-hospital (1) adverse events, (2) blood transfusion, and (3) nonroutine discharge in patients undergoing shoulder arthroplasty. Methods: Using the National Hospital Discharge Survey (NHDS) database, we identified 348,824 discharges having undergone partial or total shoulder arthroplasty from 1990 to 2007. Multivariable regression analysis was performed for each of the outcome variables. Results: The prevalence of diagnosed depressive disorder was 4.4%, anxiety disorder, 1.6%; schizophrenia, 0.6%; and dementia, 1.5%. Preoperative psychiatric disorders, with the exception of schizophrenia, were associated with higher rates of adverse events. Depression and schizophrenia were associated with higher perioperative rates of blood transfusion. Any preoperative psychiatric illness was associated with higher rates of nonroutine discharge. Conclusions: Patients with preoperative psychiatric illness undergoing shoulder arthroplasty are at increased risk for perioperative morbidity and posthospitalization care. Preoperative screening of psychiatric illness might help with planning of shoulder arthroplasty.
机译：背景：在许多医学学科中，精神病合并症与健康风险增加和长期治疗效果差有关，但其在短期围手术期环境中的作用尚不完全清楚。这项研究的目的是评估术前诊断为抑郁症，焦虑症，精神分裂症或痴呆症对住院患者（1）不良事件，（2）输血和（3）非常规出院的影响肩关节置换术。方法：使用国家医院出院调查（NHDS）数据库，我们确定了348,824例自1990年至2007年经历部分或全部肩关节置换术的出院患者。对每个结局变量进行了多变量回归分析。结果：诊断为抑郁症的患病率为4.4％，焦虑症的患病率为1.6％;精神分裂症，0.6％;和痴呆，占1.5％。除精神分裂症外，术前精神疾病与较高的不良反应率相关。抑郁和精神分裂症与围手术期更高的输血率相关。术前任何精神疾病都与非常规出院率较高有关。结论：接受肩关节置换术的术前精神疾病患者的围手术期发病率和住院后护理风险增加。术前筛查精神疾病可能有助于计划肩关节置换术。

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