Economic Effects of Anti-Depressant Usage on Elective Lumbar Fusion Surgery | ||
| The Archives of Bone and Joint Surgery | ||
| مقاله 7، دوره 4، شماره 3، مهر 2016، صفحه 231-235 اصل مقاله (422.22 K) | ||
| نوع مقاله: RESEARCH PAPER | ||
| شناسه دیجیتال (DOI): 10.22038/abjs.2016.6697 | ||
| نویسندگان | ||
| Amirali Sayadipour* 1؛ Chrisopher K. Kepler2؛ Rajnish Mago3؛ Kenneth M. Certa3؛ Mohammad R. Rasouli4؛ Alexander R. Vaccaro2؛ Todd J. Albert5؛ David G. Anderson2 | ||
| 1Department of Psychiatry, University of Maryland Medical Center, Baltimore, MD, USA | ||
| 2Rothman Institute of Orthopaedics, Thomas Jefferson University, Philadelphia, PA, USA | ||
| 3Department of Psychiatry, Thomas Jefferson University, Philadelphia, PA, USA | ||
| 4Rothman Institute of Orthopaedics, Thomas Jefferson University, Philadelphia, PA, USA Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran | ||
| 5Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran | ||
| چکیده | ||
| Background: It has been suggested, although not proven, that presence of concomitant psychiatric disorders may increase the inpatient costs for patients undergoing elective surgery. This study was designed to test the hypothesis that elective lumbar fusion surgery is more costly in patients with under treatment for depression. Methods: This is a retrospective case-control study of 142 patients who underwent elective lumbar fusion. Of those 142 patients, 41 patients were chronically using an antidepressant medication that considered as a "study group", and 101 patients were not taking an antidepressant medication that considered as a "control group". Data was collected for this cohort regarding antidepressant usage patient demographics, length of stay (LOS), age-adjusted Charlson comorbidity index scores and cost. Costs were compared between those with a concomitant antidepressant usage and those without antidepressant usage using multivariate analysis. Results: Patients using antidepressants and those with no history of antidepressant usage were similar in terms of gender, age and number of operative levels. The LOS demonstrated a non-significant trend towards longer stays in those using anti-depressants. Total charges, payments, variable costs and fixed costs were all higher in the antidepressant group but none of the differences reached statistical significance. Using Total Charges as the dependent variable, gender and having psychiatric comorbidities were retained independent variables. Use of an antidepressant was independently predictive of a 36% increase in Total Charges . Antidepressant usage as an independent variable also conferred a 22% increase in cost and predictive of a 19% increase in Fixed Cost . Male gender was predictive of a 30% increase in Total Charges . Conclusion: This study suggests use of antidepressant in patients who undergo elective spine fusion compared with control group is associated with increasing total cost and length of hospitalization, although none of the differences reached statistical significance. | ||
| کلیدواژهها | ||
| Antidepressants؛ Costs؛ Comorbidities؛ Elective lumbar fusion surgery؛ Length of hospitalization | ||
| مراجع | ||
|
1. Walid MS, Robinson JS Jr. Economic impact of comorbidities in spine surgery. J Neurosurg Spine. 2011; 14(3):318-21. 2. Walid MS, Zaytseva NV. Prevalence of mood-altering and opioid medication use among spine surgery candidates and relationship with hospital cost. J Clin Neurosci. 2010; 17(5):597-600. 3. Rasouli MR, Menendez ME, Sayadipour A, Purtill JJ, Parvizi J. Direct cost and complications associated with total joint arthroplasty in patients with preoperative anxiety and depression. J Arthroplasty. 2016; 31(2): 533–6. 4. Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987; 40(5):373–83. 5. Deyo RA, Cherkin DC, Ciol MA. Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. J Clin Epidemiol. 1992; 45(6):613-9. 6. George SZ, Coronado RA, Beneciuk JM, Valencia C, Werneke MW, Hart DL. Depressive symptoms, anatomical region, and clinical outcomes for patients seeking outpatient physical therapy for musculoskeletal pain. Phys Ther. 2011; 91(3):358-72. 7. Sinikallio S, Aalto T, Airaksinen O, Herno A, Kröger H, Savolainen S, et el. Depression and associated factors in patients with lumbar spinal stenosis. Disabil Rehabil. 2006; 28(7):415-22. 8. Sinikallio S, Aalto T, Airaksinen O, Lehto SM, Kröger H, Viinamäki H. Depression is associated with a poorer outcome of lumbar spinal stenosis surgery: a two-year prospective follow-up study. Spine (Phila Pa 1976). 2011; 36(8):677-82. 9. Zatzick DF, Kang SM, Kim SY, Leigh P, Kravitz R, Drake C, et al. Patients with recognized psychiatric disorders in trauma surgery: incidence, inpatient length of stay, and cost. J Trauma. 2000; 49(3):487-95. 10. Ebrahimzadeh MH, Shojaee BS, Golhasani-Keshtan F, Moharari F, Kachooei AR, Fattahi AS. Depression, anxiety and quality of life in caregiver spouses of veterans with chronic spinal cord injury. Iran J Psychiatry. 2014; 9(3):133-6. 11. Von Korff M, Crane P, Lane M, Miglioretti DL, Simon G, Saunders K, et al. Chronic spinal pain and physicalmental comorbidity in the United States: results from the national comorbidity survey replication. Pain. 2005; 113(3):331–9. 12. Baumeister H, Knecht A, Hutter N. Direct and indirect costs in persons with chronic back pain and comorbid mental disorders--a systematic review. J Psychosom Res. 2012; 73(2):79-85. 13. Borckardt JJ, Madan A, Barth K, Galloway S, Balliet W, Cawley PJ, et al. Excess health care service utilization and costs associated with underrecognition of psychiatric comorbidity in a medical/surgical inpatient setting. Qual Manag Health Care. 2011; 20(2):98-102. 14. Konnopka A, Heinrich S, Zieger M, Luppa M, Riedel- Heller SG, Meisel HJ, et al. Effects of psychiatric comorbidity on costs in patients undergoing disc: a cross-section study. Spine J. 2011; 11(7):601-9. 15. Hochlehnert A, Niehoff D, Wild B, Jünger J, Herzog W, Löwe B. Psychiatric comorbidity in cardiovascular inpatients: costs, net gain, and length of hospitalization. J Psychosom Res. 2011; 70(2):135-9. | ||
|
آمار تعداد مشاهده مقاله: 1,607 تعداد دریافت فایل اصل مقاله: 1,309 |
||