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The Role of Psychiatric Diagnoses for Outcome After Hip and Knee Arthroplasty

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BACKGROUND: Surgical patients receiving psychopharmacologic treatment have been associated with adverse outcomes in total hip and knee arthroplasty (THA and TKA). The purpose of this study was to investigate whether a specific high-risk group of patients receiving psychopharmacologic treatment could be identified based upon a nationwide psychiatric diagnosis register.

METHODS: From 7 different orthopedic centers, 8288 THA and TKA patients were included from January 2010 to November 2012 of which 943 (11.4%) received psychopharmacologic treatment. Patients receiving preoperative psychopharmacologic treatment were divided into 2 groups based on the presence or absence of a psychiatric diagnosis in a nationwide administrative database and analyzed with respect to length of hospital stay (LOS >4 days) and 30- and 90-day readmissions using multivariable logistic regression models.

RESULTS: A total of 191 patients receiving psychopharmacologic treatment were registered with a psychiatric diagnosis while 752 patients received psychopharmacologic treatment without a registered psychiatric diagnosis. No significantly increased risk was found in patients with a preoperative registered psychiatric diagnosis compared to patients without, with regard to LOS >4 days (odds ratio [OR], 1.19; P = .51), 30-day readmission (OR, 0.56; P = .086), or 90-day readmission (OR, 0.81; P = .446), respectively. However, both groups had an increased risk of LOS >4 days and readmissions compared to a control population without psychopharmacologic treatment or any registered psychiatric diagnoses.

CONCLUSION: No further risk was found for psychopharmacologically treated THA/TKA patients with an additional hospital-related psychiatric diagnosis compared to patients without, suggesting that the psychopharmacologic treatment per se is an outcome risk factor independent of severity of the psychiatric disorder.

Original languageEnglish
JournalThe Journal of arthroplasty
Volume32
Issue number12
Pages (from-to)3611-3615
Number of pages5
ISSN0883-5403
DOIs
Publication statusPublished - 8 Jul 2017

Bibliographical note

Members of the Lundbeck Foundation Centre for Fast-track Hip and Knee Replacement Collaborative Group are the following: Frank Madsen, DMSci, Department of Orthopedics, Aarhus University Hospital, Aarhus University, Aarhus, Denmark; Torben B. Hansen, DMSci, Department of Orthopedics, Regional Hospital Holstebro, Aarhus University, Aarhus, Denmark; Henrik Husted, DMSci, Orthopedic Department, Hvidovre University Hospital, Copenhagen University, Copenhagen, Denmark; Mogens B. Laursen, PhD, Orthopedic Division, Aalborg Hospital, Aalborg University, Aalborg, Denmark; Lars T. Hansen, MD, Orthopedic Department, Sydvestjysk Hospital Esbjerg/Grindsted, Esbjerg, Denmark; Per Kjærsgaard-Andersen, MD, Department of Orthopedics, Vejle Hospital, University of Southern Denmark, Odense, Denmark; and Søren Solgaard, DMSci, Department of Orthopedics, Gentofte University Hospital, Hellerup, Denmark.

    Research areas

  • Journal Article

ID: 51520851