RT Journal Article
SR Electronic
T1 Combined Depression and Anxiety Influence Patient-Reported Outcomes after Lumbar Fusion
JF International Journal of Spine Surgery
JO Int J Spine Surg
FD International Society for the Advancement of Spine Surgery
SP 8008
DO 10.14444/8008
A1 Dhruv K.C. Goyal
A1 Justin D. Stull
A1 Srikanth N. Divi
A1 Matthew S. Galtta
A1 Daniel R. Bowles
A1 Kristen J. Nicholson
A1 I. David Kaye
A1 Barrett I. Woods
A1 Mark F. Kurd
A1 Kris E. Radcliff
A1 Jeffrey A. Rihn
A1 D. Greg Anderson
A1 Alan S. Hilibrand
A1 Christopher K. Kepler
A1 Alexander R. Vaccaro
A1 Gregory D. Schroeder
YR 2021
UL http://ijssurgery.com//content/early/2021/02/16/8008.abstract
AB Background Currently, no studies have assessed what effect the presence of both anxiety and depression may have on patient-reported outcome measurements (PROMs) compared to patients with a single or no mental health diagnosis.Methods Patients undergoing 1- to 3-level lumbar fusion at a single academic hospital were retrospectively queried. Anyone with depression and/or anxiety was identified using an existing clinical diagnosis in the medical chart. Patients were separated into 3 groups: no depression or anxiety (NDA), depression or anxiety alone (DOA), and combined depression and anxiety (DAA). Absolute PROMs, recovery ratios, and the percentage of patients achieving minimal clinically important difference (% MCID) between groups were compared using univariate and multivariate analysis.Results Of the 391 patients included in the cohort, 323 (82.6%) were in the NDA group, 37 (9.5%) in the DOA group, and 31 (7.9%) in the DAA group. Patients in the DAA group had significantly worse outcome scores before and after surgery with respect to Short Form-12 mental component score (MCS-12) and Oswestry Disability Index (ODI) scores (P <.001); however, the change in PROMs, recovery ratio, % MCID were not found to be significantly different between groups. Using multivariate analysis, the DAA group was found to be an independent predictor of worse improvement in MCS-12 and ODI scores (P = .026 and P = .001, respectively).Conclusions Patients with combined anxiety and depression fared worse with respect to disability before and after surgery compared to patients with a single diagnosis or no mental health diagnosis; however, there were no significant differences in recovery ratio or % MCID.Level of Evidence 3.Clinical Relevance Combined anxiety and depression may predict less improvement in MCS-12 and ODI after lumbar arthrodesis compared with single or no mental health diagnosis.