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Anxiety as a Risk Factor for Postoperative Delirium in Elective Spine Deformity Surgeries: A National Database Study

Introduction Generalized anxiety disorder has become one of the most prevalent mental health disorders in the United States. In addition, postoperative delirium has been shown to increase hospital stay, increase mortality, and increased healthcare costs. Few studies have looked at the prevalence of...

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Autores principales: Freedman, Zachary, Hudock, Nicholas, Hallan, David R, Kelleher, John
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9548380/
https://www.ncbi.nlm.nih.gov/pubmed/36237769
http://dx.doi.org/10.7759/cureus.28984
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author Freedman, Zachary
Hudock, Nicholas
Hallan, David R
Kelleher, John
author_facet Freedman, Zachary
Hudock, Nicholas
Hallan, David R
Kelleher, John
author_sort Freedman, Zachary
collection PubMed
description Introduction Generalized anxiety disorder has become one of the most prevalent mental health disorders in the United States. In addition, postoperative delirium has been shown to increase hospital stay, increase mortality, and increased healthcare costs. Few studies have looked at the prevalence of postoperative delirium in patients diagnosed with anxiety undergoing elective spinal deformity procedures. The purpose of this study was to determine if anxiety is a risk factor for postoperative delirium in elective spinal deformity surgeries. Methods The authors performed a retrospective analysis using the TriNetX Research Database. Patients diagnosed with kyphosis or lordosis who then underwent elective spinal correction surgeries were identified. This group was then separated based on the diagnosis of a generalized anxiety disorder before the operation versus no diagnosis. Propensity score adjustment, based on mental disorders and other risk factors, was then used to match cohorts on baseline demographics and characteristics. Analysis was performed on the primary outcome of postoperative delirium, with secondary outcomes of upper respiratory tract infections, surgical site infections, sepsis, ventilator dependence, convulsions, stroke, emergency department visits, myocardial infarction, pulmonary embolism, and urinary retention within 30 days after surgery. Results Our search included 1,211 patients with a diagnosis of anxiety and 8,055 patients without anxiety. After propensity score matching, 996 patients remained in each cohort. Statistical analysis showed significant outcomes between the matched cohorts in the anxiety group for postoperative delirium (OR 2.788; 1.587-4.899) and convulsions (OR 1.615; 1.006-2.592). All other outcomes were not significant after propensity score matching. Conclusion These results showed generalized anxiety disorder is a risk factor for postoperative delirium and convulsions after elective spine surgery. Further research is necessary on the effects of mental health disorders on postoperative delirium and other outcomes to better understand the risks in this population.
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spelling pubmed-95483802022-10-12 Anxiety as a Risk Factor for Postoperative Delirium in Elective Spine Deformity Surgeries: A National Database Study Freedman, Zachary Hudock, Nicholas Hallan, David R Kelleher, John Cureus Neurosurgery Introduction Generalized anxiety disorder has become one of the most prevalent mental health disorders in the United States. In addition, postoperative delirium has been shown to increase hospital stay, increase mortality, and increased healthcare costs. Few studies have looked at the prevalence of postoperative delirium in patients diagnosed with anxiety undergoing elective spinal deformity procedures. The purpose of this study was to determine if anxiety is a risk factor for postoperative delirium in elective spinal deformity surgeries. Methods The authors performed a retrospective analysis using the TriNetX Research Database. Patients diagnosed with kyphosis or lordosis who then underwent elective spinal correction surgeries were identified. This group was then separated based on the diagnosis of a generalized anxiety disorder before the operation versus no diagnosis. Propensity score adjustment, based on mental disorders and other risk factors, was then used to match cohorts on baseline demographics and characteristics. Analysis was performed on the primary outcome of postoperative delirium, with secondary outcomes of upper respiratory tract infections, surgical site infections, sepsis, ventilator dependence, convulsions, stroke, emergency department visits, myocardial infarction, pulmonary embolism, and urinary retention within 30 days after surgery. Results Our search included 1,211 patients with a diagnosis of anxiety and 8,055 patients without anxiety. After propensity score matching, 996 patients remained in each cohort. Statistical analysis showed significant outcomes between the matched cohorts in the anxiety group for postoperative delirium (OR 2.788; 1.587-4.899) and convulsions (OR 1.615; 1.006-2.592). All other outcomes were not significant after propensity score matching. Conclusion These results showed generalized anxiety disorder is a risk factor for postoperative delirium and convulsions after elective spine surgery. Further research is necessary on the effects of mental health disorders on postoperative delirium and other outcomes to better understand the risks in this population. Cureus 2022-09-09 /pmc/articles/PMC9548380/ /pubmed/36237769 http://dx.doi.org/10.7759/cureus.28984 Text en Copyright © 2022, Freedman et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Neurosurgery
Freedman, Zachary
Hudock, Nicholas
Hallan, David R
Kelleher, John
Anxiety as a Risk Factor for Postoperative Delirium in Elective Spine Deformity Surgeries: A National Database Study
title Anxiety as a Risk Factor for Postoperative Delirium in Elective Spine Deformity Surgeries: A National Database Study
title_full Anxiety as a Risk Factor for Postoperative Delirium in Elective Spine Deformity Surgeries: A National Database Study
title_fullStr Anxiety as a Risk Factor for Postoperative Delirium in Elective Spine Deformity Surgeries: A National Database Study
title_full_unstemmed Anxiety as a Risk Factor for Postoperative Delirium in Elective Spine Deformity Surgeries: A National Database Study
title_short Anxiety as a Risk Factor for Postoperative Delirium in Elective Spine Deformity Surgeries: A National Database Study
title_sort anxiety as a risk factor for postoperative delirium in elective spine deformity surgeries: a national database study
topic Neurosurgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9548380/
https://www.ncbi.nlm.nih.gov/pubmed/36237769
http://dx.doi.org/10.7759/cureus.28984
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