Psychiatric Diagnoses Are Associated With Postoperative Disparities in Patients Undergoing Major Colorectal Operations.

The American Surgeon Pub Date : 2024-04-22 DOI:10.1177/00031348241248690

Alexis Webber, Shruthi R. Perati, Emily M Su, A. Ata, Todd D Beyer, Megan K Applewhite, J. Canete, Edward C. Lee

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Abstract

BACKGROUND Over 50% of hospitalized patients have comorbid psychiatric diagnoses, resulting in increased risk of morbidity such as longer lengths of stay, worse health-related quality of life, and increased mortality. However, data regarding colorectal surgery postoperative outcomes in patients with psychiatric diagnoses (PD) are limited. METHODS We queried a single institution's National Surgical Quality Improvement Program from 2013-2019 for major colorectal procedures. Postsurgical outcomes for patients with and without PD were compared. Primary outcomes were prolonged length of stay (pLOS) and 30-day readmission. RESULTS From a total of 1447 patients, 402 (27.8%) had PD. PD had more smokers (20.9% vs 15%) and higher mean body mass index (29.1 kg/m2 vs 28.2 kg/m2). Bivariate outcomes showed more surgical site infections (SSI) (10.2% vs 6.12%), reoperation (9.45% vs 6.35%), and pLOS (34.8% vs 29.0%) (all P values <.05) in the PD group. On multivariate analysis, PD had higher likelihood of reoperation (OR 1.53, 95% CI: [1.02-2.80]) and SSI (OR 1.82, 95% CI: [1.25-2.66]). DISCUSSION Psychiatric diagnoses are a risk factor for adverse outcomes after colorectal procedures. Further studies are needed to evaluate the benefit of perioperative mental health support services for these patients.

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精神病诊断与大肠直肠手术患者的术后差异有关。

背景50%以上的住院患者合并有精神病诊断，导致发病风险增加，如住院时间延长、健康相关生活质量下降和死亡率上升。然而，有关有精神疾病诊断（PD）的患者结直肠手术术后效果的数据却很有限。方法我们查询了一家机构的国家外科质量改进计划（National Surgical Quality Improvement Program）2013-2019 年主要结直肠手术的数据。我们比较了有 PD 和无 PD 患者的术后结果。主要结果为住院时间延长（pLOS）和 30 天再入院。结果在总共 1447 名患者中，402 人（27.8%）患有 PD。肺结核患者中吸烟者较多（20.9% 对 15%），平均体重指数较高（29.1 kg/m2 对 28.2 kg/m2）。双变量结果显示，PD 组的手术部位感染（SSI）（10.2% 对 6.12%）、再次手术（9.45% 对 6.35%）和 pLOS（34.8% 对 29.0%）更多（所有 P 值均小于 0.05）。在多变量分析中，PD 组再次手术（OR 1.53，95% CI：[1.02-2.80]）和 SSI（OR 1.82，95% CI：[1.25-2.66]）的可能性更高。需要进一步研究来评估围手术期心理健康支持服务对这些患者的益处。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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The American Surgeon

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