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Depression Is Associated with Prolonged and Complicated Recovery Following Colorectal Surgery

  • 2011 SSAT Quick Shot Presentation
  • Published:
Journal of Gastrointestinal Surgery

Abstract

Background

There are little data regarding the impact of depression on outcomes after gastrointestinal surgery. We hypothesize that depression would be associated with prolonged hospital stay and changes in discharge disposition for patients undergoing colon and rectal surgery.

Methods

We identified 292,191 patients undergoing colon and rectal surgery using the 2008 Nationwide Inpatient Sample. We used multivariate regression to evaluate the effect of depression on length of stay and discharge disposition.

Results

A preoperative diagnosis of depression was present in 20,039 (6.9%) patients. Mean length of stay for those with depression (10.4 days, 95% confidence interval (CI) 10.04–10.76) was significantly longer than for patients without depression (9.64 days, 95% CI 9.48–9.81). After adjusting for cofounders, depression still predicted an increase in length of stay. Additionally, depressed patients were less likely to resume normal function at discharge, as 40% required either home health or time in a skilled facility following discharge from the acute care hospital.

Conclusions

Among patients undergoing colorectal surgery, depression is associated with a significantly prolonged hospital stay and higher likelihood of requiring skilled nursing assistance after discharge. Further research into the mechanism underlying these differences and potential treatment strategies among depressed patients is warranted.

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Acknowledgments

The authors acknowledge financial support and/or resources in the preparation of this manuscript from the Houston Health Services Research and Development Center of Excellence (HF P90-020) at the Michael E. DeBakey VA Medical Center. Dr. Naik receives additional support from the National Institute on Aging (K23AG027144) and a Doris Duke Charitable Foundation Clinical Scientist Development Award. Dr. Robinson received support from a Baylor College of Medicine Comprehensive Cancer Training Program Grant (CPRIT RP 101499). These sources had no role in the preparation, review, or approval of the manuscript. The views expressed in this article are those of the authors and do not necessarily represent the views of the Department of Veterans Affairs. The authors had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

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Authors and Affiliations

  1. Operative Care Line at the Michael E. DeBakey VAMC & Department of Surgery, Baylor College of Medicine, Houston, TX, USA

    Courtney J. Balentine, Celia N. Robinson & David H. Berger

  2. Houston VA Health Services Research and Development Center of Excellence, Michael E. DeBakey VA Medical Center, Houston, TX, USA

    Courtney J. Balentine, David H. Berger & Aanand D. Naik

  3. Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX, USA

    David H. Berger & Aanand D. Naik

  4. Department of Medicine, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA

    Jesus Hermosillo-Rodriguez & Aanand D. Naik

Authors
  1. Courtney J. Balentine
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  2. Jesus Hermosillo-Rodriguez
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  3. Celia N. Robinson
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  4. David H. Berger
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  5. Aanand D. Naik
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Corresponding author

Correspondence to Aanand D. Naik.

Additional information

Courtney J. Balentine and Jesus Hermosillo-Rodriguez are co-first authors.

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Balentine, C.J., Hermosillo-Rodriguez, J., Robinson, C.N. et al. Depression Is Associated with Prolonged and Complicated Recovery Following Colorectal Surgery. J Gastrointest Surg 15, 1712–1717 (2011). https://doi.org/10.1007/s11605-011-1640-5

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  • DOI: https://doi.org/10.1007/s11605-011-1640-5

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