The impact of preoperative depression on quality of life outcomes after lumbar surgery.

Abstract

BACKGROUND CONTEXT:

Some, smaller studies have investigated the effect of preoperative depression on postoperative improvement in quality of life (QOL). However, they have not used the Patient Health Questionnaire 9 (PHQ-9) in self-reported depression.

PURPOSE:

To assess the effect of preoperative depression as measured by the PHQ-9 on postoperative improvement in QOL.

STUDY DESIGN:

A retrospective review at a single tertiary-care referral center.

PATIENT SAMPLE:

Patients who underwent lumbar decompression or fusion between 2008 and 2012.

OUTCOMES MEASURES:

A self-reported EuroQol five-dimensions (EQ-5D) quality-adjusted life-years Index.

METHODS:

Quality of life data were collected using the institutional prospectively collected database of patient-reported health status measures. The EQ-5D questionnare, PDQ, and PHQ-9 were used. Linear and logistic regression analyses were performed to assess the impact of preoperative depression on QOL improvement.

RESULTS:

Elevated preoperative pain (PDQ, β=-0.0017, p=.0009) and worsened depression (PHQ-9, β=-0.0044, p=.0359) were significantly associated with diminished postoperative improvement in QOL, as measured by the EQ-5D. Furthermore, greater depression (PHQ-9, odds ratio [OR] 0.93, p<.0001) and pain (PDQ, OR 0.99, p=.02) were associated with significantly diminished postoperative improvement exceeding the minimum clinically important difference.

CONCLUSIONS:

Increased preoperative pain and depression were shown to be associated with significantly reduced improvement in postoperative QOL, as measured by the EQ-5D.

• Authors: Jacob A Miller, Adeeb Derakhshan, Daniel Lubelski, Matthew D Alvin, Matthew J McGirt, Edward C Benzel, Thomas E Mroz
• Journal: The spine journal : official journal of the North American Spine Society (Spine J) Vol. 15 Issue 1 Pg. 58-64 (Jan 01 2015) ISSN: 1878-1632 [Electronic] United States
• PMID: 25007757 (Publication Type: Journal Article)
• Copyright: Copyright © 2015 Elsevier Inc. All rights reserved.

Topics

• Aged
• Back Pain (psychology, surgery)
• Decompression, Surgical (psychology)
• Depression (complications)
• Female
• Humans
• Lumbar Vertebrae (surgery)
• Male
• Middle Aged
• Pain Measurement
• Postoperative Period
• Preoperative Period
• Quality of Life (psychology)
• Quality-Adjusted Life Years
• Retrospective Studies
• Spinal Fusion (psychology)
• Surveys and Questionnaires
• Treatment Outcome