Charlson Comorbidity Index doesn’t include depression. Yet, it is one of the factors that can have the greatest impact on surgical outcomes.
Picasso 1904
The authors of How Does Depressive Disorder Impact Outcomes in Patients with Glenohumeral Osteoarthritis Undergoing Primary Reverse Shoulder Arthroplasty? sought to compare in-hospital length of stay (LOS); medical complications; emergency department (ED) utilizations; and cost of care for patients with and without depression disorder undergoing primary reverse total shoulder (RSA).
They retrospectively analyzed a database of administrative claims nationwide to find 28,410 patients who had undergone primary RSA treatment for glenohumeral Osteoarthritis. Interestingly, of these 14% (4,084) had ICD 9 or ICD 10 codes for depression disorder (DD).
Patients with DD who underwent primary RSA experienced a significantly longer stay and a higher incidence of complications, such as myocardial attacks, cerebrovascular accidents and pneumonia.
In the 90 days following surgery, patients with DD had a 2- to 3-fold increase in ED usage.
Comment: The data is interesting in two ways: the first, it shows how many patients have medical complications within 90 days.
