What happens to patients undergoing cancer surgery with psychiatric comorbidities?: A nationwide retrospective cohort study

Abstract

Objective We aimed to describe the surgical outcomes and readmissions rates in patients with psychological comorbidities who underwent surgical intervention for cancer. Background The Hospital Readmission Reduction Program, a campaign by the Affordable Care Act, penalizes hospitals for greater readmission rates. One prevalent patient risk factor associated with hospital readmission is a comorbid psychiatric condition. Currently, no studies exist identifying psychiatric comorbidities and their effects on patients with cancer undergoing surgical intervention. Methods A cross‐sectional analysis was performed using the Nationwide Readmissions Database for 2010–2014 and included adult patients undergoing cancer resection operations. Multivariable logistic regression analyses were utilized to assess determinants of surgical outcomes and readmissions. Results Of 1 016 636 eligible patients, 11.6% had psychiatric comorbidities. Patients with psychiatric disorders had greater risks of mortality (odds ratio [OR] = 1.21, 95% confidence interval [CI] = 1.18–1.25), complications (OR = 1.51, 95%CI = 1.50–1.52), extended length of stay (OR = 1.21, 95%CI = 1.20–1.22), and incurred healthcare expenditure at primary admission (OR = 1.16, 95% CI = 1.15–1.18). Psychiatric comorbidities were associated with an increased likelihood of readmission (OR = 1.13, 95%CI = 1.11–1.15). Conclusions Concomitant psychiatric conditions were attributed to poor surgical outcomes and a higher risk of readmissions. Multidisciplinary care within the perioperative setting should be encouraged for patients with psychiatric disorders.

Complicações pós-cirúrgicas em pacientes idosos: revisão integrativa de literatura

“…O avançar da idade, a queda na eficiência do processo de cicatrização e a redução da função cardiovascular podem representar um aumento do risco perioperatório deste subgrupo de pacientes oncológicos (Bartley et al, 2022). No entanto, pacientes que estejam considerando a reconstrução mamária imediata devem ser informadas de que a idade não necessariamente implicará em um maior risco de perda da reconstrução (Shenhar et al, 2022;Toraih et al, 2022).…”

“…Os octogenários correspondem a uma população em expansão, frequentemente frágil ou com comorbidades (Cooter Wright et al, 2022). Além disso, espera-se que a taxa de complicações seja maior e a sobrevida menor quando comparada com pacientes mais jovens (Toraih et al, 2022). A demanda por cuidados aumenta com a idade e é maior entre os muitos idososcom 80 anos ou mais, grupo populacional que mais cresce (Shenhar et al, 2022).…”