Psychiatric Comorbidity Ups 30-Day Surgical Mortality

Individually, patients with either anxiety or depression pre-admission are at risk
By Lindsey Marcellin
HealthDay Reporter

THURSDAY, Oct. 21 (HealthDay News) -- Surgical patients with a preexisting psychiatric comorbidity have a greater 30-day post-surgical mortality risk, according to research published in the October issue of the Archives of Surgery.

Thad E. Abrams, M.D., of the University of Iowa Carver College of Medicine in Iowa City, and colleagues conducted a retrospective cohort study of 35,539 surgical patients admitted to Veterans Health Administration hospital intensive care units. The purpose of the study was to assess the effect of five psychiatric comorbidities on post-surgical mortality.

A preexisting psychiatric diagnosis of depression, anxiety, posttraumatic stress disorder, bipolar disease, or schizophrenia was identified in 25.1 percent of admitted surgical patients. The researchers found the adjusted 30-day post-surgical mortality to be 21 percent higher in the psychiatric comorbidity group than in the group of surgical patients without preexisting comorbidity. Individually, patients with anxiety and depression, but not the other comorbidities, had significantly greater odds of 30-day mortality.

"Until further research is completed, we recommend that surgeons caring for patients with a history of anxiety or depression seek early involvement of multidisciplinary teams to help identify problematic areas in perioperative care processes, particularly regarding issues of surgeon-patient communication and adherence to post-surgical recommendations," the authors write.

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