Preoperative depression screening reduced complications, costs after lumbar fusion
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Key takeaways:
- A depression screening before lumbar fusion was associated with decreased complications, ED utilizations and costs for patients with depressive disorder.
- Patients without a screening had worse outcomes.
According to presented results, a preoperative depression screening within 3 months of lumbar fusion was associated with decreased medical complications, ED utilizations and health care costs.
“The WHO has postulated that depression will be one of the leading causes of morbidity and mortality by 2030,” Mitchell K. Ng, MD, said during his presentation at the North American Spine Society Annual Meeting.
“Patients with mental health disorders have been shown to have poor pain tolerance, increased catastrophizing and decreased resilience following stressors including surgeries,” he added.
Using the PearlDiver database, Ng and colleagues performed a retrospective cohort analysis of data from patients with depressive disorder who underwent primary one- to two-level lumbar fusion between 2010 and 2020. They analyzed two 1:5 matched cohorts of 2,622 patients with and 13,058 without a preoperative depression screening or a psychotherapy visit within 3 months of surgery.
According to the abstract, primary outcome measures were collected at 90 days postoperatively and included medical complications, ED utilizations, readmissions and costs of care.
Overall, patients with depressive disorder who did not receive a depression screening prior to surgery had significantly greater incidence and odds of experiencing a medical complication at 90 days compared with patients who received a depression screening (40.57% vs. 16%; OR = 2.71). Patients who did not receive a depression screening also had greater incidence and odds of ED utilization at 90 days (15.78% vs. 4.23%; OR = 4.25) compared with patients who received a depression screening.
Ng and colleagues found no differences in incidences or odds of readmission at 90 days between the groups (9.31% vs. 9.53%; OR = 0.97). However, Ng noted patients who did not receive a depression screening had significantly increased reimbursements at 90 days compared with patients who received a depression screening ($51,160 vs. $54,731).
“Spine surgeons treating patients with depression may consider recommending a depression screening prior to one- to two-level lumbar fusion,” Ng concluded.
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Ng MK, et al. Paper 71. Presented at: North American Spine Society Annual Meeting; Oct. 18-21, 2023; Los Angeles.
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