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01-12-2019 | Mood Disorders | Original Article

The impact of preoperative anxiety, depression, and chronic pain on outcomes in abdominal wall reconstruction

Authors: K. A. Schlosser, S. R. Maloney, T. Prasad, K. Kercher, B. T. Heniford, V. A. Augenstein

Published in: Hernia | Issue 6/2019

Abstract

Purpose

An association of anxiety with surgical outcomes has been suggested, including with open ventral hernia repair (OVHR). This study examines the interaction of multiple comorbidities, including anxiety, depression, chronic pain, and hernia characteristics with outcomes after OVHR.

Methods

Patients with anxiety were identified in an existing, prospectively collected, data set of OVHR with preoperative work-up including CT scans (2007–2018). A patient with a diagnosis or prescription for anxiolytics, anti-depressants, or narcotics was considered to have anxiety, depression, or chronic pain, respectively. Hernia characteristics were analyzed using 3D volumetric software. Univariate and multivariate analyses were performed to assess for the impact of anxiety on surgical outcomes.

Results

A total of 1178 OVHRs were identified. The diagnosis of anxiety (23.9%) was associated with female gender (29.1% females vs. 16.9% males, p = 0.002), depression (56.7 vs. 18.8%, p < 0.0001), preoperative chronic pain (43.6 vs. 26.9%, p < 0.0001), COPD, arrhythmia, history of MRSA, and sleep apnea (p ≤ 0.05 all values). Patients with anxiety had larger hernia volume and defect size, and were more likely to undergo component separation, with higher rates of wound complication and intervention for pain (p ≤ 0.05 all values). After multivariate analysis controlling for multiple potentially confounding factors, the comorbidities of anxiety, depression, and preoperative chronic pain were not found to be significantly associated with adverse outcomes.

Conclusions

The diagnosis of anxiety is associated with preoperative comorbidity, surgical complexity, and adverse outcomes after OVHR. However, when comorbidities are controlled for, the diagnosis of anxiety, depression or preoperative pain does not independently predict adverse outcomes. In this context, anxiety may be considered a marker of patient comorbidity in a complex patient population.

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Title: The impact of preoperative anxiety, depression, and chronic pain on outcomes in abdominal wall reconstruction
Authors: K. A. Schlosser
S. R. Maloney
T. Prasad
K. Kercher
B. T. Heniford
V. A. Augenstein
Publication date: 01-12-2019
Publisher: Springer Paris
Keywords: Mood Disorders
Affective Disorder
Chronic Obstructive Lung Disease
Anxiety
Published in: Hernia / Issue 6/2019
Print ISSN: 1265-4906
Electronic ISSN: 1248-9204
DOI: https://doi.org/10.1007/s10029-019-02059-8

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The impact of preoperative anxiety, depression, and chronic pain on outcomes in abdominal wall reconstruction

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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