Effect of Mental Health Disorders on 30-Day Postoperative Outcomes After Surgical Fixation of Distal Radius Fractures.

Background: There is scarce literature describing the effects of mental health disorders (MHDs) on outcomes of distal radius fractures (DRFs). Major depressive disorder (MDD), generalized anxiety disorder (GAD), and post-traumatic stress disorder (PTSD) are the leading psychiatric ailments in the United States. This study evaluates how mental health affects postoperative outcomes after surgical for DRFs.

Methods: The TriNetX research network was queried for DRFs treated operatively. Patients with MDD, GAD, and PTSD were identified and stratified among the cohorts. Data were collected using Current Procedural Terminology and International Classification of Diseases codes. Cohorts were propensity matched to control for demographics and comorbidities. Demographic information was obtained. Outcomes including reoperation, infection, opioid use, and health care utilization were obtained at 30 days. Prevalence, risk ratios, and associated P values were calculated.

Results: The MDD, GAD and PTSD cohorts had 4198, 4527, and 1658 patients each, respectively. Mental health disorder cohorts were more likely to use emergency department (ED) services and have readmissions compared with controls (P < .01). The MHD groups were more likely to use occupational therapy (OT) resources and postoperative visits (P < .01). The MDD group was 9% (P < .01) less likely to use opioids, whereas the PTSD group was 15% (P < .01) more likely.

Conclusion: Mental health disorders were associated with more postoperative emergency department and inpatient services. Individuals with MHDs were less likely to attend postoperative visits and use occupational therapy resources, which could explain poorer postoperative outcomes reported in other studies. Post-traumatic stress disorder had a higher opioid usage. Mental health disorders have significant impacts on postoperative outcomes for DRF, and practitioners should direct their efforts at these deficiencies in early postoperative care.