Depression is Associated With Prolonged and Complicated Recovery Following Colorectal Surgery

Balentine, Courtney J.; Naik, Aanand D.; Robinson, Christina M.; Hermosillo-Rodriguez, Jesus; Berger, David H.

doi:10.1016/s0016-5085(11)64167-x

Cited by 33 publications

(13 citation statements)

References 39 publications

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“…Third, the maximum number of listed diagnoses in the NHDS database is seven, which might underestimate medical conditions such as chronic stable mental disorders. Fourth, administrative databases tend to underreport psychiatric diagnoses by orthopaedic surgeons when using administrative databases, which may be the case for our study given that the prevalence of psychiatric diagnosis in our study population was only 3.2%, whereas the prevalence in the US population is approximately 10% [2,32,37]. Fifth, specific data such as medication use were not at our disposal; therefore, we had no evidence of adequate treatment of concurrent psychiatric disorders before hospital admission.…”

Section: Discussionmentioning

confidence: 88%

Do Psychiatric Comorbidities Influence Inpatient Death, Adverse Events, and Discharge After Lower Extremity Fractures?

Menendez

Neuhaus

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et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background Psychiatric comorbidity is known to contribute to illness (the state of feeling unwell/unable to rely on one's body) and increased use of healthcare resources, but the effect on inpatient outcomes in fracture care is relatively unexplored. Questions/purposes Our primary null hypothesis is that a concomitant diagnosis of depression, anxiety, dementia, or schizophrenia is not associated with (1) discharge to another care facility rather than home after lower extremity fractures. Secondary study questions address the associations between psychiatric comorbidity and (2) longer inpatient stay and inpatient (3) adverse events; (4) blood transfusion; and (5) mortality after lower extremity fractures. Methods Using the National Hospital Discharge Survey database, we analyzed a total estimated number of 10,669,449 patients with lower limb fractures from 1990 to 2007. Sixty-four percent were women, and the mean ± SD age was 67 ± 22 years. The prevalence in the study population was 3.2% for depression, 1.6% for anxiety, 0.6% for schizophrenia, and 2.9% for dementia. Results A discharge diagnosis of psychiatric comorbidity was associated with a lower rate of discharge to home after accounting for an association with greater medical comorbidity (schizophrenia: odds ratio [OR], 5.6, 95% confidence interval [CI], 5.5-5.8; dementia: OR, 1.3, 95% CI, 1.2-1.3; depression: OR, 1.2, 95% CI, 1.2-1.3; anxiety: OR, 1.04, 95% CI, 1.02-1.06). Hospital stay was longer for patients with schizophrenia and dementia but shorter in patients with depression or anxiety compared with patients without any mental disorders. Schizophrenia was associated with more in-hospital adverse events and depression and anxiety with fewer events. A diagnosis of depression was associated with blood transfusion. Psychiatric comorbidity was not associated with a higher risk of in-hospital death.

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Section: Discussionmentioning

confidence: 88%

Do Psychiatric Comorbidities Influence Inpatient Death, Adverse Events, and Discharge After Lower Extremity Fractures?

Menendez

Neuhaus

Bot

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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“…Although not frequently investigated among lung transplant recipients, numerous studies in other surgical populations have demonstrated that elevated depressive symptoms, or history of depression, may portend worse perioperative risk through several mechanisms , including delayed response engaging in rehabilitation , elevated preoperative inflammation , and greater incidence of postoperative delirium . In addition, at least one study among liver transplant recipients demonstrated that the presence of pretransplant depression was associated with longer LOS and survival .…”

Section: Discussionmentioning

confidence: 99%

Depression, social support, and clinical outcomes following lung transplantation: a single-center cohort study

et al. 2017

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Depressive symptoms are common among lung transplant candidates and have been associated with poorer clinical outcomes in some studies. Previous studies have been plagued by methodologic problems, including small sample sizes, few clinical events, and uncontrolled confounders, particularly perioperative complications. In addition, few studies have examined social support as a potential protective factor. We therefore examined the association between pretransplant depressive symptoms, social support, and mortality in a large sample of lung transplant recipients. As a secondary aim, we also examined the associations between psychosocial factors, perioperative outcomes [indexed by hospital length of stay (LOS)], and mortality. We hypothesized that depression would be associated with longer LOS and that the association between depression, social support, and mortality would be moderated by LOS. Participants included lung transplant recipients, transplanted at Duke University Medical Center from January 2009 to December 2014. Depressive symptoms were evaluated using the Beck Depression Inventory (BDI-II) and social support using the Perceived Social Support Scale (PSSS). Medical risk factors included forced vital capacity (FVC), partial pressure of carbon dioxide (PCO ), donor age, acute rejection, and transplant type. Functional status was assessed using six-minute walk distance (6MWD). We also controlled for demographic factors, including age, gender, and native disease. Transplant hospitalization LOS was examined as a marker of perioperative clinical outcomes. Participants included 273 lung recipients (174 restrictive, 67 obstructive, 26 cystic fibrosis, and six "other"). Pretransplant depressive symptoms were common, with 56 participants (21%) exhibiting clinically elevated levels (BDI-II ≥ 14). Greater depressive symptoms were associated with longer LOS [adjusted b = 0.20 (2 days per 7-point higher BDI-II score), P < 0.01]. LOS moderated the associations between depressive symptoms (P = 0.019), social support (P < 0.001), and mortality, such that greater depressive symptoms and lower social support were associated with greater mortality only among individuals with longer LOS. For individuals with LOS ≥ 1 month, clinically elevated depressive symptoms (BDI-II ≥ 14) were associated with a threefold increased risk of mortality (HR = 2.97). Greater pretransplant depressive symptoms and lower social support may be associated with greater mortality among a subset of individuals with worse perioperative outcomes.

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“…Length of stay (LoS) and the risk of morbidity within 30 days after colorectal surgery have been shown to be negatively affected by a number of factors; for example, age more than 75 years (Feroci et al, 2013;Hendry et al, 2009), high comorbidity (Ahmed, Lim, Khan, McNaught, & MacFie, 2010;Feroci et al, 2013;Hendry et al, 2009;Kahokehr, Sammour, Sahakian, Zargar-Shoshtari, & Hill, 2011), male gender, and rectal surgery (Hendry et al, 2009). In addition, the duration of surgery (Keller et al, 2014), the presence of an ileostomy (Feroci et al, 2013;Smart et al, 2012), as well as depression, have been shown to predict an increase in LoS (Balentine, Hermosillo-Rodriguez, Robinson, Berger, & Naik, 2011). Depression was reported to predict a 6% increase in LoS (Balentine et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

“…In addition, the duration of surgery (Keller et al, 2014), the presence of an ileostomy (Feroci et al, 2013;Smart et al, 2012), as well as depression, have been shown to predict an increase in LoS (Balentine, Hermosillo-Rodriguez, Robinson, Berger, & Naik, 2011). Depression was reported to predict a 6% increase in LoS (Balentine et al, 2011). Furthermore, preoperative neoadjuvant therapy, with either radiation therapy or chemotherapy, has been shown to predict a fourfold risk of readmission within 30 days after surgery (Francis et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

Patient characteristics and surgery-related factors associated with patient-reported recovery at 1 and 6 months after colorectal cancer surgery

2017

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Predictors for postoperative recovery after colorectal cancer surgery are usually investigated in relation to length of stay (LoS), readmission, or 30-day morbidity. This study describes patient characteristics and surgery-related factors associated with patient-reported recovery 1 and 6 months after surgery. In total, 153 consecutively included patients who were recovering from colorectal cancer surgery reported their level of recovery using the Postoperative Recovery Profile. Multiple logistic regression analysis was used to calculate associations with recovery, defined as good or poor, divided into five recovery dimensions: physical symptoms, physical functions, psychological, social and activity. Better preoperative health predicted good recovery regarding three dimensions 1 month after surgery. Regarding all dimensions 1 month after surgery, poor recovery was predicted by a poor recovery on the day of discharge within corresponding dimensions. Higher age was associated with good recovery 6 months after surgery, while chemotherapy showed negative associations. Overall, a majority of factors had a negative impact on recovery, but without any obvious relation to one specific dimension or point in time. Those factors were: high Body Mass Index, comorbidity, abdominoperineal resection, loop ileostomy, colostomy and LoS. This study illustrates the complexity of postoperative recovery and a need for individualised follow-up strategies.

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Depression is Associated With Prolonged and Complicated Recovery Following Colorectal Surgery

Cited by 33 publications

References 39 publications

Do Psychiatric Comorbidities Influence Inpatient Death, Adverse Events, and Discharge After Lower Extremity Fractures?

Do Psychiatric Comorbidities Influence Inpatient Death, Adverse Events, and Discharge After Lower Extremity Fractures?

Depression, social support, and clinical outcomes following lung transplantation: a single-center cohort study

Patient characteristics and surgery-related factors associated with patient-reported recovery at 1 and 6 months after colorectal cancer surgery

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