Patients with depression may have increased rates of complications after TKA
Click Here to Manage Email Alerts
Key takeaways:
- Patients with depression had increased odds of readmission and reoperation after total knee arthroplasty.
- However, these patients had a reduced odds of hospital mortality.
SAN FRANCISCO — Results presented here showed patients with depression undergoing total knee arthroplasty experienced an increased risk of medical and surgical complications, readmissions and reoperations.
“Some possible explanations that we have been exploring is that there have been some studies that have shown a link between antidepressants and osteoporosis, as well as links between depression and falls,” Travis M. Kotzur, BS, third-year medical student at UT Health San Antonio, said in his presentation at the American Academy of Orthopaedic Surgeons Annual Meeting. “Future research should aim to identify these relationships and work toward optimizing these patients so that their postoperative course can be better watched and understood.”
Using the National Readmissions Database from 2016 to 2019, Kotzur and colleagues identified patients diagnosed with depression and collected demographics and comorbidities among approximately 2 million patients who underwent TKA. Researchers assessed overall patient comorbidity burden with a weighted Elixhauser Comorbidity Index.
“For our outcomes, we included medical and surgical complications within 30 days of surgery,” Kotzur said. “We also included arthroplasty specific complications, such as joint infection, dislocation and periprosthetic fracture.”
Overall, Kotzur said 16% of patients had depression. Patients in the depressed cohort had an increased odds of readmission of 54% and reoperation of 62%. However, patients in the depressed cohort had a reduced odds of hospital mortality of 53%, according to Kotzur.
“For medical complications, we saw an increase in the rate of pneumonia by about 67%, [deep venous thrombosis] DVT by about 20%, osteomyelitis by 44% and sepsis by 54%,” Kotzur said. “For surgical complications, we saw all-cause surgical complications increased by about 37% in our depressed cohort. We saw wound disruptions increased by 9%, joint infection by 87% and periprosthetic fracture by 116%.”
Collapse
Kotzur TM, et al. Paper 80. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; Feb. 12-16, 2024; San Francisco.
Click Here to Manage Email Alerts