Abstract
Objective
To examine the relative incidence of newly recorded diagnosis of depression after
spinal surgery as a proxy for the risk of post–spinal surgery depression.
Patients and Methods
We used the longitudinal California Office of Statewide Health Planning and Development
database (January 1, 2000, through December 31, 2010) to identify patients who underwent
spinal surgery during these years. Patients with documented depression before surgery
were excluded. Risk of new postoperative depression was determined via the incidence
of newly recorded depression on any hospitalization subsequent to surgery. For comparison,
this risk was also determined for patients hospitalized during the same time period
for coronary artery bypass grafting, hysterectomy, cholecystectomy, chronic obstructive
pulmonary disease, congestive heart failure exacerbation, or uncomplicated vaginal
delivery.
Results
Our review identified 1,078,639 patients. Relative to the uncomplicated vaginal delivery
cohort, the adjusted hazard ratios (HRs) for newly recorded depression within 5 years
after the admission of interest were 5.05 for spinal surgery (95% CI, 4.79-5.33),
2.33 for coronary artery bypass grafting (95% CI, 2.15-2.54), 3.04 for hysterectomy
(95% CI, 2.88-3.21), 2.51 for cholecystectomy (95% CI, 2.35-2.69), 2.44 for congestive
heart failure exacerbation (95% CI, 2.28-2.61), and 3.04 for chronic obstructive pulmonary
disease (95% CI, 2.83-3.26). Among patients who underwent spinal surgery, this risk
of postoperative depression was highest for patients who underwent fusion surgery
(HR, 1.28; 95% CI, 1.22-1.36) or had undergone multiple spinal operations (HR, 1.22;
95% CI, 1.16-1.29) during the analyzed period.
Conclusion
Patients who undergo spinal surgery have a higher risk for postoperative depression
than patients treated for other surgical or medical conditions known to be associated
with depression.
Abbreviations and Acronyms:
CABG (coronary artery bypass grafting), CHF (congestive heart failure), COPD (chronic obstructive pulmonary disease), HR (hazard ratio), ICD-9-CM (International Classification of Diseases, Ninth Revision, Clinical Modification), OSHPD (Office of Statewide Health Planning and Development)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: November 08, 2016
Footnotes
Grant Support: This work was supported in part by grant 1TL1TR001443 from the National Institutes of Health.
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© 2016 Mayo Foundation for Medical Education and Research
