Association between psychological health and wound complications after surgery

作者：Britteon P^*; Cullum N; Sutton M

来源：British Journal of Surgery, 2017, 104(6): 769-776.

DOI：10.1002/bjs.10474

BackgroundSurgical wound complications remain a major cause of morbidity, leading to higher costs and reduced quality of life. Although psychological health is widely considered to affect wound healing, the evidence on wound outcomes after surgery is mixed. Studies generally focus on small samples of patients undergoing a specific procedure and have limited statistical power.
MethodsThis study investigated the relationship between three different measures of anxiety and/or depression and seven adverse surgical outcomes using observational data collected before and after surgery between 2009 and 2011. A wide range of confounding factors was adjusted for, including patient demographics, physical co-morbidities, health-related behaviours, month of operation, procedure complexity and treating hospital.
ResultsThe estimation sample included 176827 patients undergoing 59410 hip replacements, 64145 knee replacements, 38328 hernia repairs and 14944 varicose vein operations. Patients with moderate anxiety or depression had an increased probability of wound complications after a hip replacement (odds ratio (OR) 117, 95 per cent c.i. 111 to 124). They were more likely to be readmitted for a wound complication (OR 120, 102 to 141) and had an increased duration of hospital stay by 019 (95 per cent c.i. 015 to 024) days. Estimated associations were consistent across all four types of operation and for each measure of anxiety and/or depression.
ConclusionPreoperative psychological health is a significant risk factor for adverse wound outcomes after surgery for four of the procedures most commonly performed in England.
Anxious and depressed patients get more complications

• 出版日期2017-5