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Do psychiatric disorders affect patient reported outcomes and clinical outcomes post total hip and knee arthroplasty?

INTRODUCTION: The purpose of this study is to evaluate the role of major psychiatric illness on patient outcomes after total joint arthroplasty. METHODS: Patients with a diagnosis of a major psychiatric disorder undergoing total joint arthroplasty were retrospectively matched one-to-one with a cohor...

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Autores principales: Kooner, Sahil, Kubik, Jeremy, Mahdavi, Saboura, Piroozfar, Sophie (Ghashang), Khong, Hoa, Mohan, Kanwal, Batuyong, Eldridge, Sharma, Rajrishi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8107666/
https://www.ncbi.nlm.nih.gov/pubmed/33996082
http://dx.doi.org/10.1177/20503121211012254
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author Kooner, Sahil
Kubik, Jeremy
Mahdavi, Saboura
Piroozfar, Sophie (Ghashang)
Khong, Hoa
Mohan, Kanwal
Batuyong, Eldridge
Sharma, Rajrishi
author_facet Kooner, Sahil
Kubik, Jeremy
Mahdavi, Saboura
Piroozfar, Sophie (Ghashang)
Khong, Hoa
Mohan, Kanwal
Batuyong, Eldridge
Sharma, Rajrishi
author_sort Kooner, Sahil
collection PubMed
description INTRODUCTION: The purpose of this study is to evaluate the role of major psychiatric illness on patient outcomes after total joint arthroplasty. METHODS: Patients with a diagnosis of a major psychiatric disorder undergoing total joint arthroplasty were retrospectively matched one-to-one with a cohort without such a diagnosis. Major psychiatric disorder in the registry was identified by diagnosis of anxiety, mood, or a psychotic disorder. Primary outcome of interest included perioperative Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Secondary outcomes included EuroQol-5D, adverse events, length of stay, 30-day readmission, and discharge destination. RESULTS: Total number of patients were 1828. The total hip arthroplasty (37.80 ± 17.91, p = 0.023) and the total knee arthroplasty psychiatric group (43.38 ± 18.41, p = 0.050) had significantly lower pre-operative WOMAC scores. At 3 months, the total hip arthroplasty (76.74 ± 16.94, p = 0.036) and total knee arthroplasty psychiatric group (71.09 ± 18.64, p < 0.01) again had significantly lower 3-month post-operative WOMAC score compared to the control groups. However, outcomes at 1 year were difficult to interpret, as patients with major psychiatric conditions had an extremely high loss to follow-up. Compared to the control groups, the total hip arthroplasty and total knee arthroplasty psychiatric group had an increased length of stay by 1.43 days (p < 0.01) and 0.77 days, respectively (p = 0.05). Similarly, the psychiatric groups were discharged directly home less often (total hip arthroplasty 86.9%, p = 0.024 and total knee arthroplasty 87.6%, p = 0.022) than the control groups. CONCLUSION: Patients with the diagnosis of a major psychiatric illness have an increased length of stay and are more likely to require a rehabilitation facility, compared to the control groups. Arguably, of utmost importance, there is a very high rate of loss to follow-up within the psychiatric groups. As such, we recommend these patients should be treated for their diagnosis prior to total joint arthroplasty. Furthermore, importance of clinical follow-up should be emphasized carefully.
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spelling pubmed-81076662021-05-14 Do psychiatric disorders affect patient reported outcomes and clinical outcomes post total hip and knee arthroplasty? Kooner, Sahil Kubik, Jeremy Mahdavi, Saboura Piroozfar, Sophie (Ghashang) Khong, Hoa Mohan, Kanwal Batuyong, Eldridge Sharma, Rajrishi SAGE Open Med Original Research Article INTRODUCTION: The purpose of this study is to evaluate the role of major psychiatric illness on patient outcomes after total joint arthroplasty. METHODS: Patients with a diagnosis of a major psychiatric disorder undergoing total joint arthroplasty were retrospectively matched one-to-one with a cohort without such a diagnosis. Major psychiatric disorder in the registry was identified by diagnosis of anxiety, mood, or a psychotic disorder. Primary outcome of interest included perioperative Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Secondary outcomes included EuroQol-5D, adverse events, length of stay, 30-day readmission, and discharge destination. RESULTS: Total number of patients were 1828. The total hip arthroplasty (37.80 ± 17.91, p = 0.023) and the total knee arthroplasty psychiatric group (43.38 ± 18.41, p = 0.050) had significantly lower pre-operative WOMAC scores. At 3 months, the total hip arthroplasty (76.74 ± 16.94, p = 0.036) and total knee arthroplasty psychiatric group (71.09 ± 18.64, p < 0.01) again had significantly lower 3-month post-operative WOMAC score compared to the control groups. However, outcomes at 1 year were difficult to interpret, as patients with major psychiatric conditions had an extremely high loss to follow-up. Compared to the control groups, the total hip arthroplasty and total knee arthroplasty psychiatric group had an increased length of stay by 1.43 days (p < 0.01) and 0.77 days, respectively (p = 0.05). Similarly, the psychiatric groups were discharged directly home less often (total hip arthroplasty 86.9%, p = 0.024 and total knee arthroplasty 87.6%, p = 0.022) than the control groups. CONCLUSION: Patients with the diagnosis of a major psychiatric illness have an increased length of stay and are more likely to require a rehabilitation facility, compared to the control groups. Arguably, of utmost importance, there is a very high rate of loss to follow-up within the psychiatric groups. As such, we recommend these patients should be treated for their diagnosis prior to total joint arthroplasty. Furthermore, importance of clinical follow-up should be emphasized carefully. SAGE Publications 2021-04-29 /pmc/articles/PMC8107666/ /pubmed/33996082 http://dx.doi.org/10.1177/20503121211012254 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Research Article
Kooner, Sahil
Kubik, Jeremy
Mahdavi, Saboura
Piroozfar, Sophie (Ghashang)
Khong, Hoa
Mohan, Kanwal
Batuyong, Eldridge
Sharma, Rajrishi
Do psychiatric disorders affect patient reported outcomes and clinical outcomes post total hip and knee arthroplasty?
title Do psychiatric disorders affect patient reported outcomes and clinical outcomes post total hip and knee arthroplasty?
title_full Do psychiatric disorders affect patient reported outcomes and clinical outcomes post total hip and knee arthroplasty?
title_fullStr Do psychiatric disorders affect patient reported outcomes and clinical outcomes post total hip and knee arthroplasty?
title_full_unstemmed Do psychiatric disorders affect patient reported outcomes and clinical outcomes post total hip and knee arthroplasty?
title_short Do psychiatric disorders affect patient reported outcomes and clinical outcomes post total hip and knee arthroplasty?
title_sort do psychiatric disorders affect patient reported outcomes and clinical outcomes post total hip and knee arthroplasty?
topic Original Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8107666/
https://www.ncbi.nlm.nih.gov/pubmed/33996082
http://dx.doi.org/10.1177/20503121211012254
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