Ahad A Kesaria, Saadi M Irfan, Tristan X Nguyen, Jeffrey L Shi, Verdinand C B Ruelos, William M Weiss
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引用次数: 0
Abstract
Background: This study evaluated the association between diagnosed mental health disorders and postoperative outcomes following Achilles repair.
Methods: A retrospective cohort study was performed using the TriNetX database over a 20-year period. Patients were divided into 2 cohorts based on whether they had a documented mental health disorder (eg, anxiety or depression) 1 year preceding surgery. Cohorts were propensity score matched by demographics such as age, gender, body mass index, diabetes, and hypertension. Outcomes were measured 90 days, 3 years, and up to 10 years using odds ratios with 95% CIs. χ2 analysis was performed with significance noted at P <.05.
Results: Matched cohorts had a mean age of 48.5 years in the mental health cohort and 49.6 years in the control cohort, with 47.4% vs 47.1% female patients, respectively. A total of 1841 patients were included in each cohort. Within 90 days postoperative, patients with diagnosed mental health disorders demonstrated several significant outcomes such as higher odds of orthopaedic aftercare (P = .032), infection following a procedure (P < .0001), postoperative pain (P < .0001), emergency department visit (P < .0001), ankle pain (P = .004), cellulitis of lower limb (P < .0001), and foot pain (P = .009). Within 3 years postoperative, these patients had significantly higher odds of knee pain (P = .008), ankle osteoarthritis (P = .003), Achilles tendonitis (P = .008), and abnormalities of gait and mobility (P = .020). Within 10 years postoperative, these patients had significantly higher odds of ankle osteoarthritis (P = .006).
Conclusion: Diagnosed mental health disorders are associated with increased short- and long-term adverse postoperative outcomes in patients who underwent Achilles repair at a population level. These associations included increased infection rates and pain, as well as later musculoskeletal diagnoses such as ankle osteoarthritis and abnormalities with gait.
Level of evidence: Level III, retrospective, comparative cohort study.
背景：本研究评估了被诊断出的精神健康障碍与跟腱修复术后预后之间的关系。方法：使用TriNetX数据库进行回顾性队列研究，时间跨度超过20年。根据患者在手术前1年是否有记录的精神健康障碍（如焦虑或抑郁），将患者分为2组。队列的倾向评分与人口统计学相匹配，如年龄、性别、体重指数、糖尿病和高血压。使用95% ci的比值比测量90天、3年和长达10年的结果。结果：匹配队列中，精神健康组和对照组的平均年龄分别为48.5岁和49.6岁，女性患者分别为47.4%和47.1%。每个队列共纳入1841例患者。在术后90天内，被诊断为精神健康障碍的患者表现出几个显著的结果，如更高的骨科术后护理几率(P =。032)，手术后感染(P P P P =。004)，下肢蜂窝织炎（P P = .009）。术后3年内，这些患者出现膝关节疼痛的几率明显增高(P =。008)，踝关节骨关节炎(P =。003)，跟腱炎(P =。008)，步态和活动异常（P = .020）。术后10年内，这些患者患踝关节骨关节炎的几率显著增高（P = 0.006）。结论：在人群水平上，诊断出的精神健康障碍与接受跟腱修复的患者的短期和长期不良术后结局增加相关。这些关联包括增加感染率和疼痛，以及后来的肌肉骨骼诊断，如踝关节骨关节炎和步态异常。证据等级：III级，回顾性，比较队列研究。
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