Anxiety’s Impact on Length of Stay Following Lumbar Spinal Surgery

Floyd, Hollis; Sanoufa, Mazen; Robinson, Joe Sam

doi:10.7812/tpp/15-022

Cited by 10 publications

(3 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Floyd et al showed that anxiety has an impact on the length of stay following lumbar spinal surgery 29 with patients taking anxiolytics staying 1.8 days longer in the hospital. Another recent literature review 30 highlighted how patients with the underlying psychological disease tend to present higher rates of delirium, readmission, longer hospital stays, and higher rates of nonroutine discharge following spine surgery, as well as higher rates of chronic postoperative narcotic use and may experience worse surgical outcomes.…”

Section: Discussionmentioning

confidence: 99%

Does the Association Between Psychosocial Factors and Opioid Use After Elective Spine Surgery Differ by Sex in Older Adults?

Aglio,

Mezzalira,

Corey

et al. 2023

JPR

View full text Add to dashboard Cite

Purpose Psychosocial disorders have been linked to chronic postoperative opioid use and the development of postoperative pain. The potential interaction between sex and psychosocial factors with respect to opioid use after elective spine surgery in the elderly has not yet been evaluated. Our aim was to assess whether any observed association of anxiety or depression indicators with opioid consumption in the first 72 hours after elective spine surgery varies by sex in adults ≥65 years. Patients and Methods Secondary analysis of a retrospective cohort of 647 elective spine surgeries performed at Brigham and Women’s Hospital, July 1, 2015–March 15, 2017, in patients ≥65. Linear mixed-effects models were used to test whether history of anxiety, anxiolytic use, history of depression, and antidepressant use were associated with opioid consumption 0–24, 24–48, and 48–72 post surgery, and whether these potential associations differed by sex. Results History of anxiety, anxiolytic use, history of depression, and antidepressant use were more common among women (51.3% of the sample). During the first 24 hours after surgery, men with a preoperative history of anxiety consumed an adjusted mean of 19.5 morphine milligram equivalents (MME) (99.6% CI: 8.1, 31.0) more than men without a history of anxiety; women with a history of anxiety only consumed an adjusted mean 2.9 MME (99.6% CI: −3.1, 8.9) more than women without a history of anxiety (P value for interaction between sex and history of anxiety <0.001). No other interactions were detected between sex and psychosocial factors with respect to opioid use after surgery. Conclusion Secondary analysis of this retrospective cohort study found minimal evidence that the association between psychosocial factors and opioid consumption after elective spine surgery differs by sex in adults ≥65.

show abstract

Section: Discussionmentioning

confidence: 99%

Does the Association Between Psychosocial Factors and Opioid Use After Elective Spine Surgery Differ by Sex in Older Adults?

Aglio,

Mezzalira,

Corey

et al. 2023

JPR

View full text Add to dashboard Cite

show abstract

“…This finding has some plausible explanations. Patients with an increased anxiety level are more often reluctant to leave the hospital earlier, as they may worry about being challenged with the extent of disability and a new everyday reality at home [ 18 , 19 ]. At the same time, a prolonged hospital stay may represent a source of anxiety itself, when patients are becoming increasingly concerned about the postoperative course not going exactly according to plan.…”

Section: Discussionmentioning

confidence: 99%

Educational and Psychological Support Combined with Minimally Invasive Surgical Technique Reduces Perioperative Depression and Anxiety in Patients with Bladder Cancer Undergoing Radical Cystectomy

Lemiński

Kaczmarek

Bańcarz

et al. 2021

IJERPH

View full text Add to dashboard Cite

Radical cystectomy (RC) for muscle-invasive bladder cancer (MIBC) is an extensive and morbid operation, often associated with permanent alteration of body image and disability. Combined with the aggressive malignant potential of MIBC and considerable risk of complications, it poses a serious threat to the psychological well-being of patients. Educational deficiencies causing uncertainty and confusion aggravate surgery-related anxiety and may lead to depression along with further social disability. We conceived a preoperative supportive program named “Cystocare” held by urologists, psychologists, stoma therapists and cancer survivors to facilitate patients’ adaptation and coping. We aimed to evaluate whether participation in Cystocare meetings would alleviate emotional distress in patients undergoing RC. We included 95 consecutive patients who filled Hospital Anxiety and Depression Score questionnaires before RC and on discharge. The intervention arm (A) comprised 32 Cystocare participants. The remaining 63 patients who received standard preparation constituted the control arm (B). Whilst there were no differences in median anxiety and depression scores preoperatively, in postoperative measurement, the intervention arm showed a lower median depression score than controls: 3 vs. 8 points, p = 0.015. On multivariate analysis we confirmed lower risk of postoperative depression in Cystocare participants: OR = 0.215 (95%CI: 0.066–0.699), p = 0.011, along with lower odds of preoperative anxiety in patients undergoing laparoscopic RC: OR = 0.365 (95%CI: 0.136–0.978), p = 0.045, and higher risk of prolonged hospital stay in patients experiencing postoperative anxiety OR = 17.114 (95%CI: 1.283–228.234) p = 0.032. Preoperative educational and supportive intervention complements laparoscopic RC in the alleviation of surgery-related anxiety and depression. The support group meetings provide an attractive and cost-effective opportunity to moderate emotional response in patients undergoing RC, and as such, deserve widespread adoption.

show abstract

“…This nding has some plausible explanations. Patients with an increased anxiety level are more often reluctant to leave the hospital earlier, as they may worry about being challenged with new everyday reality after the surgery at home [18,19]. At the same time, a prolonged hospital stay may represent a source of anxiety itself, when patients are becoming increasingly concerned about the postoperative course not going exactly according to plan.…”

Section: Discussionmentioning

confidence: 99%

Educational and Psychological Support Combined with Minimally Invasive Surgery Reduces Perioperative Depression and Anxiety in Patients with Bladder Cancer Treated with Radical Cystectomy.

Lemiński

Kaczmarek

Słojewski

2021

Preprint

View full text Add to dashboard Cite

PurposeRadical cystectomy (RC) for muscle-invasive bladder cancer (MIBC) is an extensive and morbid operation, often associated with a permanent alteration of body image. Combined with aggressive malignant potential of MIBC and considerable risk of complications, it may pose a serious threat to psychological well-being of patients. Educational deficiencies not infrequently encountered in everyday hospital practice, may lead to confusion and further aggravate procedure-related emotional distress. We conceived a preoperative informational and supportive program named “Cystocare”, with monthly meetings held by a team of urologists, stoma therapist, psychologists and cancer survivors to facilitate patients’ adaptation and coping. We aimed to evaluate whether participation in Cystocare meetings would alleviate emotional distress in patients undergoing RC.MethodsWe included 95 consecutive patients who agreed to participate and returned Hospital Anxiety and Depression Score (HADS) questionnaires before RC and on discharge. The intervention arm (A) comprised 32 patients who participated in meetings, the remaining 63 constituted controls (B). Patients from arm A were significantly younger than controls (mean age arm A: 64.7 SD 8.25; arm B: 68.8 SD 7.87), there were no further differences between study arms.ResultsWe found no differences between groups in median anxiety and depression scores preoperatively. In postoperative measurement, the intervention arm showed significantly lower median depression score than controls: 3 vs 8 points, p=0.015, while the anxiety score remained comparable. On multivariate analysis we found lower odds of preoperative anxiety in patients planned for laparoscopic RC OR=0.351 (95%CI: 0.139-0.884), p=0.026, lower risk of postoperative depression in patients from arm A OR=0.253 (95% CI: 0.087-0.732) p=0.011 and higher risk of postoperative anxiety in patients whose length of stay exceeded 7 days OR=9.48 (95%CI: 1,146-78,428) p=0.037. ConclusionsPreoperative educational and supportive intervention combined with minimally invasive approach to RC seem effective in alleviation of surgery-related anxiety and depression.

show abstract

Anxiety’s Impact on Length of Stay Following Lumbar Spinal Surgery

Cited by 10 publications

References 6 publications

Does the Association Between Psychosocial Factors and Opioid Use After Elective Spine Surgery Differ by Sex in Older Adults?

Does the Association Between Psychosocial Factors and Opioid Use After Elective Spine Surgery Differ by Sex in Older Adults?

Educational and Psychological Support Combined with Minimally Invasive Surgical Technique Reduces Perioperative Depression and Anxiety in Patients with Bladder Cancer Undergoing Radical Cystectomy

Educational and Psychological Support Combined with Minimally Invasive Surgery Reduces Perioperative Depression and Anxiety in Patients with Bladder Cancer Treated with Radical Cystectomy.

Contact Info

Product

Resources

About