Depression and psychotic disorders worsen perioperative outcomes and increase resource utilization after multilevel lumbar fusion: Implications for screening and perioperative care.

Publication/Presentation Date

1-1-2026

Abstract

CONTEXT: Multilevel lumbar fusion use has increased with an aging U.S. population. Depression and psychotic disorders are linked to poorer surgical outcomes, but their effects in this setting are unclear.

AIMS: The aims of this study were to quantify the prevalence of these disorders and evaluate associations with perioperative outcomes and resource use.

SETTINGS AND DESIGN: This was a retrospective cohort study using the National Inpatient Sample from 2016 to 2022.

SUBJECTS AND METHODS: Depression and psychotic disorders were defined using Elixhauser-derived indicators. Outcomes included medical and mechanical complications, discharge disposition, length of stay (LOS), and costs.

STATISTICAL ANALYSIS USED: Chi-square and logistic regression analyses were performed, with significance at the

RESULTS: Among 458,180 weighted admissions, 18.6% had depression and 2.5% had psychoses. Compared to patients without these diagnoses, depression was associated with higher odds of cardiovascular complications (odds ratio [OR]: 1.25,

CONCLUSIONS: Depression and psychotic disorders are common among patients undergoing multilevel lumbar fusion and are associated with higher healthcare utilization.

Volume

17

Issue

2

First Page

138

Last Page

144

ISSN

0974-8237

Disciplines

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

PubMedID

41929745

Department(s)

Administration and Leadership

Document Type

Article

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