title: Anxiety's Impact on Length of Stay Following Lumbar Spinal Surgery.
abstract: BACKGROUND
  Despite some evidence that anxiety may affect length of stay (LOS), relatively little inquiry exists regarding this in neurosurgical literature.
  
  
  OBJECTIVE
  To determine the influence of anxiety on LOS after elective lumbar decompression and fusion (LDF) surgery.
  
  
  METHODS
  The medical records of 307 patients who consecutively underwent elective LDF surgery from October 1, 2010, through September 30, 2013, were retrospectively reviewed. Each patient's medications and comorbidities were determined using the medical history. The impact of their medications on LOS was studied using multivariate analysis. Linear regression was also used to assess the relationship between anxiolytic use and LOS. An independent sample t test was used to compare the mean LOS of the group of patients receiving muscle relaxants with that of the group who were not.
  
  
  RESULTS
  Those with a diagnosis of anxiety who were taking anxiolytics (n = 32) stayed 1.8 days longer than those with no diagnosis of anxiety and who were not taking anxiolytics (n = 224) after LDF surgery (p = 0.003). Those with a diagnosis of anxiety who were taking anxiolytics (n = 32) stayed 1.9 days longer than those with no diagnosis of anxiety and who were taking anxiolytics (n = 24) after LDF surgery (p = 0.003).
  
  
  CONCLUSIONS
  Our study suggests that those with a diagnosis of anxiety who take medications for that condition have a longer LOS than those with no diagnosis of anxiety and who are not medicated for the condition. This could be because these patients are more vulnerable to states of anxiety when required to be nil per os for 12 hours before surgery.
authors.affiliation: Research Assistant at the Georgia Neurosurgical Institute in Macon. hollisfloyd@gmail.com.
authors.forename: Hollis
authors.initials: H
authors.lastname: Floyd
authors.affiliation: Research Fellow at the Georgia Neurosurgical Institute in Macon. mazensanoufa@gmail.com.
authors.forename: Mazen
authors.initials: M
authors.lastname: Sanoufa
authors.affiliation: Neurosurgeon at the Georgia Neurosurgical Institute in Macon. jrobinson@ganeuroandspine.com.
authors.forename: Joe Sam
authors.initials: JS
authors.lastname: Robinson
mesh_terms: D000367:Age Factors; D000368:Aged; D014151:Anti-Anxiety Agents / Q000008:administration & dosage; D001007:Anxiety / Q000188:drug therapy / Q000453:epidemiology*; D015897:Comorbidity; D019299:Decompression, Surgical / Q000523:psychology*; D017558:Elective Surgical Procedures / Q000523:psychology; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data*; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D013123:Spinal Fusion / Q000523:psychology*
chemical_list: D014151:Anti-Anxiety Agents