Is Depression Associated With Worse Outcomes Among Women Undergoing Breast Reconstruction Following Mastectomy?
James Drinane, D.O., Thuy-Huong Pham, M.D., Jin Sol Oh, M.D., Andrew Harner, M.D., Edmond Ritter, M.D..
Medical College of Georgia at Augusta University, augusta, GA, USA.
Background: The purpose of this study is to determine if depressed women undergoing breast reconstruction have worse outcomes? Despite a plethora of data examining the effect of depression after reconstruction there is little information to assess if concurrent depression affects patient outcomes in a similar manner. To answer this question we undertook a retrospective study using the Nationwide Inpatient Sample (NIS).
Methods: The NIS was queried for 2010-2013 for all patients undergoing breast reconstruction after mastectomy. Patients with a diagnosis of depression at the time of operation were compared to those without depression . Chi-squared, students’t-test, and risk-adjusted multivariate logistic regression were performed with SPSS. A p value <0.05 was considered significant.
Results: A total of 175,508 patients were included in this study. 35,473 had depression at time of breast reconstruction and 140,035 did not. Depression was associated with an increased age, length of stay, cost of care, more comorbidities, and higher incidence of pulmonary, hematologic, gastrointestinal, infectious, wound and venous thromboembolic complications, p<0.05 (Table 1). Pulmonary, Genitourinary, and Hematologic complications, Infection, VTE, wound, and transfusion were associated with depression when multivariate risk-adjusted regression was performed (Table 2).
Conclusions: A co-morbid diagnosis at time of breast reconstruction should prompt the breast surgeon and plastic surgeon to ensure that depressed patients have their depression addressed prior to undergoing breast reconstruction to ensure optimal patient outcomes.
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