Depression influences post-op satisfaction in older patients
Owoicho Adogwa, M.D., M.P.H., from Duke University Medical Center in Durham, N.C., and colleagues examined the impact of preoperative depression on patient satisfaction after revision lumbar surgery. The cohort included 69 patients aged 65 years or older undergoing revision neural decompression and instrumented fusion for same-level recurrent stenosis-associated back and leg pain. For all patients the authors assessed preoperative Zung self-rating depression score, comorbidities, and postoperative satisfaction with surgical care and outcome.
The researchers found that after surgery there was a statistically significant improvement in visual analog score (VAS)-back pain and VAS-leg pain compared with baseline. After surgery, the two-year Oswestry Disability Index improved for pseudarthrosis, adjacent segment disease, and same-level recurrent stenosis. There was an independent correlation between increasing preoperative Zung self-rated depression scale scores and patient dissatisfaction two years after revision lumbar surgery, in a multivariate logistic regression model (P < 0.001).
"Quality improvement initiatives using patient satisfaction as a proxy for quality of care should account for patients' baseline depression as a potential confounder especially in this age group," the authors write.
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