Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Sep 21:8:100223.
doi: 10.1016/j.bjao.2023.100223. eCollection 2023 Dec.

New onset postoperative depression after major surgery: an analysis from a national claims database

Brian O'Gara  1 , Juan Pablo Espinosa Leon  1 , Kortney Robinson  2 , Maximilian Schaefer  1 , Daniel Talmor  1 , Michael Fischer  3
Affiliations

New onset postoperative depression after major surgery: an analysis from a national claims database

Brian O'Gara et al. BJA Open. .

Abstract

Background: Postoperative depression is not well characterised. We investigated the incidence of postoperative depression with the hypothesis that after controlling for confounders, new onset depression would vary significantly by surgical type.

Methods: We conducted a retrospective cohort study using the Optum Clinformatics Datamart. The primary outcome was new onset postoperative depression, defined by a new diagnosis of depression or new prescription for an antidepressant in the year after surgery using International Classification of Diseases (ICD) 9/10 codes and drug names. Adjustment for preoperative comorbidities and predictors of depression was with multivariable Cox regression and propensity score matching. Sensitivity analyses defining new onset depression as both a new diagnosis of depression and a new prescription for an antidepressant, or either outcome separately, were conducted.

Results: Data from 132 390 cardiac surgery, 12 538 thoracotomy, 32 630 video-assisted thoracoscopic surgery (VATS), 96 750 hip fracture surgery, 157 484 hip replacement, and 347 878 laparoscopic cholecystectomy patients from January 2004 to June 2021 were analysed. The incidence of new onset postoperative depression was 18.8% for hip fracture surgery, 16.1% for thoracotomy, 12.6% for cardiac surgery, 12.4% for VATS, 8.6% for laparoscopic cholecystectomy, and 6.8% for hip replacement. After multivariable adjustment, hip fracture surgery patients were most likely to develop new onset postoperative depression (hazard ratio [95% confidence interval]) 1.56 [1.45-1.68]), followed by thoracotomy (1.12 [1.03-1.22]), cardiac surgery (1.09 [1.04-1.12]), VATS (0.95 [0.90-1.00]), and hip replacement (0.55 [0.52-0.57]) compared with patients undergoing laparoscopic cholecystectomy (hazard ratio=1). Results from propensity score matched analyses and sensitivity analyses were similar.

Conclusions: The risk of postoperative depression differs by surgical type after controlling for preoperative characteristics.

Keywords: major surgery; national database; postoperative depression; propensity matching.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Multivariable adjusted odds of new onset postoperative depression by surgery type. Laparoscopic cholecystectomy was assigned as the reference group (OR=1). Error bars represent 95% confidence intervals. CI, confidence interval; VATS, video-assisted thoracoscopic surgery.
None
figs1
None
figs2
None
figs3
None
figs4
None
figs5
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. World Health Organization . WHO; Geneva: 2017. Depression and other common mental disorders: global health estimates.
    1. Bisschop M.I., Kriegsman D.M., Deeg D.J., Beekman A.T., van Tilburg W. The longitudinal relation between chronic diseases and depression in older persons in the community: the Longitudinal Aging Study Amsterdam. J Clin Epidemiol. 2004;57:187–194. - PubMed
    1. Cole M.G., Dendukuri N. Risk factors for depression among elderly community subjects: a systematic review and meta-analysis. Am J Psychiatry. 2003;160:1147–1156. - PubMed
    1. Egede L.E. Major depression in individuals with chronic medical disorders: prevalence, correlates and association with health resource utilization, lost productivity and functional disability. Gen Hosp Psychiatry. 2007;29:409–416. - PubMed
    1. Lichtman J.H., Bigger J.T., Blumenthal J.A., et al. Depression and coronary heart disease. Circulation. 2008;118:1768–1775. - PubMed