Journal of surgical oncology | 2021
What happens to patients undergoing cancer surgery with psychiatric comorbidities?: A nationwide retrospective cohort study.
Abstract
OBJECTIVE\nWe aimed to describe the surgical outcomes and readmissions rates in patients with psychological comorbidities who underwent surgical intervention for cancer.\n\n\nBACKGROUND\nThe Hospital Readmission Reduction Program, a campaign by the Affordable Care Act, penalizes hospitals for greater readmission rates. One prevalent patient risk factor associated with hospital readmission is a comorbid psychiatric condition. Currently, no studies exist identifying psychiatric comorbidities and their effects on patients with cancer undergoing surgical intervention.\n\n\nMETHODS\nA cross-sectional analysis was performed using the Nationwide Readmissions Database for 2010-2014 and included adult patients undergoing cancer resection operations. Multivariable logistic regression analyses were utilized to assess determinants of surgical outcomes and readmissions.\n\n\nRESULTS\nOf 1\u2009016\u2009636 eligible patients, 11.6% had psychiatric comorbidities. Patients with psychiatric disorders had greater risks of mortality (odds ratio [OR]\u2009=\u20091.21, 95% confidence interval [CI]\u2009=\u20091.18-1.25), complications (OR\u2009=\u20091.51, 95%CI\u2009=\u20091.50-1.52), extended length of stay (OR\u2009=\u20091.21, 95%CI\u2009=\u20091.20-1.22), and incurred healthcare expenditure at primary admission (OR\u2009=\u20091.16, 95% CI\u2009=\u20091.15-1.18). Psychiatric comorbidities were associated with an increased likelihood of readmission (OR\u2009=\u20091.13, 95%CI\u2009=\u20091.11-1.15).\n\n\nCONCLUSIONS\nConcomitant psychiatric conditions were attributed to poor surgical outcomes and a higher risk of readmissions. Multidisciplinary care within the perioperative setting should be encouraged for patients with psychiatric disorders.