TY - JOUR
T1 - Depression Is Associated with Prolonged and Complicated Recovery Following Colorectal Surgery
AU - Balentine, Courtney J.
AU - Hermosillo-Rodriguez, Jesus
AU - Robinson, Celia N.
AU - Berger, David H.
AU - Naik, Aanand D.
N1 - Funding Information:
Acknowledgments The authors acknowledge financial support and/ or resources in the preparation of this manuscript from the Houston Health Services Research and Development Center of Excellence (HF P90-020) at the Michael E. DeBakey VA Medical Center. Dr. Naik receives additional support from the National Institute on Aging (K23AG027144) and a Doris Duke Charitable Foundation Clinical Scientist Development Award. Dr. Robinson received support from a Baylor College of Medicine Comprehensive Cancer Training Program Grant (CPRIT RP 101499). These sources had no role in the preparation, review, or approval of the manuscript. The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs. The authors had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
PY - 2011/10
Y1 - 2011/10
N2 - Background: There are little data regarding the impact of depression on outcomes after gastrointestinal surgery. We hypothesize that depression would be associated with prolonged hospital stay and changes in discharge disposition for patients undergoing colon and rectal surgery. Methods: We identified 292,191 patients undergoing colon and rectal surgery using the 2008 Nationwide Inpatient Sample. We used multivariate regression to evaluate the effect of depression on length of stay and discharge disposition. Results: A preoperative diagnosis of depression was present in 20,039 (6. 9%) patients. Mean length of stay for those with depression (10. 4 days, 95% confidence interval (CI) 10. 04-10. 76) was significantly longer than for patients without depression (9. 64 days, 95% CI 9. 48-9. 81). After adjusting for cofounders, depression still predicted an increase in length of stay. Additionally, depressed patients were less likely to resume normal function at discharge, as 40% required either home health or time in a skilled facility following discharge from the acute care hospital. Conclusions: Among patients undergoing colorectal surgery, depression is associated with a significantly prolonged hospital stay and higher likelihood of requiring skilled nursing assistance after discharge. Further research into the mechanism underlying these differences and potential treatment strategies among depressed patients is warranted.
AB - Background: There are little data regarding the impact of depression on outcomes after gastrointestinal surgery. We hypothesize that depression would be associated with prolonged hospital stay and changes in discharge disposition for patients undergoing colon and rectal surgery. Methods: We identified 292,191 patients undergoing colon and rectal surgery using the 2008 Nationwide Inpatient Sample. We used multivariate regression to evaluate the effect of depression on length of stay and discharge disposition. Results: A preoperative diagnosis of depression was present in 20,039 (6. 9%) patients. Mean length of stay for those with depression (10. 4 days, 95% confidence interval (CI) 10. 04-10. 76) was significantly longer than for patients without depression (9. 64 days, 95% CI 9. 48-9. 81). After adjusting for cofounders, depression still predicted an increase in length of stay. Additionally, depressed patients were less likely to resume normal function at discharge, as 40% required either home health or time in a skilled facility following discharge from the acute care hospital. Conclusions: Among patients undergoing colorectal surgery, depression is associated with a significantly prolonged hospital stay and higher likelihood of requiring skilled nursing assistance after discharge. Further research into the mechanism underlying these differences and potential treatment strategies among depressed patients is warranted.
KW - Colorectal surgery
KW - Depression
KW - Outcomes
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U2 - 10.1007/s11605-011-1640-5
DO - 10.1007/s11605-011-1640-5
M3 - Article
C2 - 21786060
AN - SCOPUS:80053131755
SN - 1091-255X
VL - 15
SP - 1712
EP - 1717
JO - Journal of Gastrointestinal Surgery
JF - Journal of Gastrointestinal Surgery
IS - 10
ER -