title: Impact of Affective Disorders on Recovery of Baseline Function in Patients Undergoing Spinal Surgery: A Single Institution Study of 275 Patients.
abstract: BACKGROUND
  Decompressive spinal surgery patients have high expectations of recovering functionally, both at work and with leisurely activities. Affective disorders, such as depression or anxiety, are increasingly prevalent in this population and are associated with poorer baseline quality-of-life measures and worse postoperative outcomes. The study examined the results of affective disorders on self-reported recovery of baseline function (RBF) following decompressive spinal surgery.
  
  
  METHODS
  Medical records of 275 patients undergoing elective decompressive spinal surgery at a major academic institution were reviewed. There were 101 (36.7%) patients (with diagnosed anxiety or depression) in the affective disorder cohort (ADC) and 174 (63.6%) patients in the control cohort. The main outcome measure was self-reported RBF 3 months after surgery. Multivariate regression analysis was also used to determine whether affective disorders were a risk factor for poor RBF.
  
  
  RESULTS
  Baseline demographics, comorbidities, and perioperative variables between the two cohorts were similar, except for a higher proportion of females, more smokers, and longer length of stay in the ADC. On patient-reported outcome measures, the ADC had significantly decreased baseline scores and decreased improvement in scores over time. On univariate analysis, the ADC had significantly lower rates of RBF at 3 months after surgery. On regression analysis, affective disorders were an independent risk factors for poor RBF.
  
  
  CONCLUSIONS
  This study suggests that affective disorders are an independent risk factor for decreased recovery of baseline functionality after decompressive spinal surgery. Preoperatively identifying these patients could improve management of postoperative expectations and thereby improve surgical outcome.
authors.affiliation: Department of Neurological Surgery, Duke University Medical Center, Durham, NC.
authors.forename: Gautam
authors.initials: G
authors.lastname: Nayar
authors.affiliation: Department of Neurological Surgery, Duke University Medical Center, Durham, NC.
authors.forename: Aladine A
authors.initials: AA
authors.lastname: Elsamadicy
authors.affiliation: Department of Neurological Surgery, Duke University Medical Center, Durham, NC.
authors.forename: Rasheedat
authors.initials: R
authors.lastname: Zakare-Fagbamila
authors.affiliation: Department of Neurological Surgery, Duke University Medical Center, Durham, NC.
authors.forename: Julia
authors.initials: J
authors.lastname: Farquhar
authors.affiliation: Department of Neurological Surgery, Duke University Medical Center, Durham, NC. Electronic address: oren.gottfried@duke.edu.
authors.forename: Oren N
authors.initials: ON
authors.lastname: Gottfried
mesh_terms: D015897:Comorbidity; D019299:Decompression, Surgical; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000150:complications* / Q000453:epidemiology; D015999:Multivariate Analysis; D010359:Patient Readmission; D000071066:Patient Reported Outcome Measures; D011183:Postoperative Complications; D011446:Prospective Studies; D020127:Recovery of Function; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D057566:Self Report; D013131:Spine / Q000601:surgery*
keywords: Affective disorders; Anxiety; Decompressive spinal surgery; Depression; Postoperative recovery; Recovery of baseline function