The Impact of Mental Illness on Postoperative Adverse Outcomes After Outpatient Joint Surgery

Abstract Background The effect of pre-existing mental illness on outpatient surgical outcomes is not well characterized. The objective of this study was to evaluate the association between preexisting mental illness diagnosis and postoperative complications following outpatient total knee (TKA) and total hip arthroplasty (THA) and 2) compare to inpatient total joint arthroplasty (TJA). Methods The Mariner Claims Database was used to capture patients undergoing outpatient TJA from 2010-2017. Patients were grouped into three categories: those with an existing history of anxiety and/or depression, those with severe mental illness, and those without history of mental illness. Additional subgroup analysis compared those with severe mental illness undergoing outpatient versus inpatient TJA. Outcomes were analyzed using multivariable logistic regression (p Results Patients undergoing outpatient TJA with prior history of anxiety and/or depression or severe mental illness had an increased risk of emergency department (ED) visits (TKA, p Conclusion Anxiety/depression and severe mental illness are associated with higher rates of ED visits following outpatient TJA. Patients with severe mental illness also experienced more adverse events, whereas those with anxiety and/or depression had similar rates compared to control. A higher rate of adverse outcomes was seen following TKA in patients with severe mental illness when surgery was done in the outpatient setting versus those that had surgery as an inpatient.