Electronic Communication Patterns Could Reflect Preoperative Anxiety and Serve as an Early Complication Warning in Elective Spine Surgery Patients with Affective Disorders: A Retrospective Analysis of a Cohort of 1199 Elective Spine Patients

Zachary K. Christian, Salah G. Aoun, Olusoji Afuwape, Emmanuel Adeyemo, Umaru Barrie, Olatunde Badejo, Luke J. Dosselman, Mark N. Pernik, Kristen Hall, Valery Peinado Reyes, Tarek Y. El Ahmadieh, Mazin Al Tamimi, Carlos A. Bagley

Research output: Contribution to journalArticle

Abstract

Objective: The analysis of perioperative electronic patient portal (EPP) communication may provide risk stratification and insight for complication prevention in patients with affective disorders (ADs). We aimed to understand how patterns of EPP communication in patients with AD relate to preoperative narcotic use, surgical outcomes, and readmission rates. Methods: The records of adult patients who underwent elective spinal surgery between January 2010 and August 2017 at a single institution were retrospectively reviewed for analysis. Primary outcomes included preoperative narcotic use, the number of perioperative EPP messages sent, rates of perioperative complications, hospital length of stay, emergency department (ED) visits within 6 weeks, and readmissions within 30 days after surgery. Results: A total of 1199 patients were included in the analysis. Patients with an AD were more likely to take narcotics before surgery (51.69% vs. 41%, P < 0.001) and to have active EPP accounts (75.36% vs. 69.75%, P = 0.014) compared with controls. They were also more likely to send postoperative messages (38.89% vs. 32.75%, P = 0.030) and tended to send more messages (0.67 vs. 0.48, P = 0.034). The AD group had higher rates of postoperative complications (8.21% vs. 3.98%, P = 0.001), ED visits (4.99% vs. 2.43%, P = 0.009), and readmissions postoperatively (2.49% vs. 1.38%, P = 0.049). Conclusions: AD patients have specific patterns of perioperative EPP communication. They are at a higher risk of postoperative complications. Addressing these concerns early may prevent more serious morbidity and avoid unnecessary ED visits and readmissions, thus reducing costs and improving patient care.

Original languageEnglish (US)
Pages (from-to)e888-e893
JournalWorld neurosurgery
Volume141
DOIs
StatePublished - Sep 2020

Keywords

  • Affective disorder
  • Depression
  • Electronic patient communication
  • Electronic patient portal
  • Outcome
  • Spine outcomes
  • Spine surgery health care cost

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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