Combined Depression and Anxiety Influence Patient-Reported Outcomes after Lumbar Fusion.

Authors

• Dhruv K C Goyal
• Justin D Stull
• Srikanth N Divi
• Matthew S Galetta
• Daniel R Bowles
• Kristen J Nicholson
• I David Kaye
• Barrett I Woods
• Mark F Kurd
• Kris E Radcliff
• Jeffrey A Rihn
• D Greg Anderson
• Alan S Hilibrand
• Christopher K Kepler
• Alexander R Vaccaro
• Gregory D Schroeder

Publication/Presentation Date

4-1-2021

Abstract

BACKGROUND: Currently, no studies have assessed what effect the presence of both anxiety and depression may have on patient-reported outcome measurements (PROMs) compared to patients with a single or no mental health diagnosis.

METHODS: Patients undergoing 1- to 3-level lumbar fusion at a single academic hospital were retrospectively queried. Anyone with depression and/or anxiety was identified using an existing clinical diagnosis in the medical chart. Patients were separated into 3 groups: no depression or anxiety (NDA), depression or anxiety alone (DOA), and combined depression and anxiety (DAA). Absolute PROMs, recovery ratios, and the percentage of patients achieving minimal clinically important difference (% MCID) between groups were compared using univariate and multivariate analysis.

RESULTS: Of the 391 patients included in the cohort, 323 (82.6%) were in the NDA group, 37 (9.5%) in the DOA group, and 31 (7.9%) in the DAA group. Patients in the DAA group had significantly worse outcome scores before and after surgery with respect to Short Form-12 mental component score (MCS-12) and Oswestry Disability Index (ODI) scores (

CONCLUSIONS: Patients with combined anxiety and depression fared worse with respect to disability before and after surgery compared to patients with a single diagnosis or no mental health diagnosis; however, there were no significant differences in recovery ratio or % MCID.

LEVEL OF EVIDENCE: 3.

CLINICAL RELEVANCE: Combined anxiety and depression may predict less improvement in MCS-12 and ODI after lumbar arthrodesis compared with single or no mental health diagnosis.

Volume

15

Issue

2

First Page

234

Last Page

242

ISSN

2211-4599

Published In/Presented At

Goyal, D. K. C., Stull, J. D., Divi, S. N., Galetta, M. S., Bowles, D. R., Nicholson, K. J., Kaye, I. D., Woods, B. I., Kurd, M. F., Radcliff, K. E., Rihn, J. A., Anderson, D. G., Hilibrand, A. S., Kepler, C. K., Vaccaro, A. R., & Schroeder, G. D. (2021). Combined Depression and Anxiety Influence Patient-Reported Outcomes after Lumbar Fusion. International journal of spine surgery, 15(2), 234–242. https://doi.org/10.14444/8008

Disciplines

Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods

PubMedID

33900980

Department(s)

Administration and Leadership

Document Type

Article