ArticleClinical orthopaedics and related research2013
Do psychiatric comorbidities influence inpatient death, adverse events, and discharge after lower extremity fractures?
Article in Clinical orthopaedics and related research, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 3 of them syntheses that pooled it.
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Who cites it
14 citing papers in PubMed, 3 syntheses or guidelines pooled it, 45 citations in OpenAlex.
- The neglected association between schizophrenia and bone fragility: a systematic review and meta-analyses.Translational psychiatry · 2024Pooled it
- Severe mental illness and health service utilisation for nonpsychiatric medical disorders: A systematic review and meta-analysis.PLoS medicine · 2020Pooled it
- Lower Bone Mineral Density at the Hip and Lumbar Spine in People with Psychosis Versus Controls: a Comprehensive Review and Skeletal Site-Specific Meta-analysis.Current osteoporosis reports · 2016Pooled it
- Association Between Depression and Increased Odds of Inpatient Mortality Following Hip Fracture Repair.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2026Article
- Distinct Patient Characteristics and Risk Profiles in Upper vs. Lower Leg Fractures: Insights from a Comprehensive Cohort Study.Diagnostics (Basel, Switzerland) · 2025Article
- Anxiety and depression are associated with heightened risk of incident deep vein thrombosis: Mediation through stress-related neural mechanisms.American journal of hematology · 2024Article
- Delayed Scaphoid Fracture Union in Patients With Comorbid Psychiatric Diagnoses: A Retrospective Analysis of 20 340 Patients.Hand (New York, N.Y.) · 2024Article
- Article
- Emotional Distress in a Patients Following Polytrauma.Journal of multidisciplinary healthcare · 2023Article
- Clinical outcomes following major trauma for patients with a diagnosis of depression: a large UK database analysis.Trauma surgery & acute care open · 2021Article
- Article
- Association between dementia and discharge status in patients hospitalized with pneumonia.BMC pulmonary medicine · 2017Article
- Inpatient mortality after orthopaedic surgery.International orthopaedics · 2015Article
- The Elixhauser comorbidity method outperforms the Charlson index in predicting inpatient death after orthopaedic surgery.Clinical orthopaedics and related research · 2014Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPsychiatric comorbidity is known to contribute to illness (the state of feeling unwell/unable to rely on one's body) and increased use of healthcare resources, but the effect on inpatient outcomes in fracture care is relatively unexplored. QUESTIONS/PURPOSES: Our primary null hypothesis is that a concomitant diagnosis of depression, anxiety, dementia, or schizophrenia is not associated with (1) discharge to another care facility rather than home after lower extremity fractures. Secondary study questions address the associations between psychiatric comorbidity and (2) longer inpatient stay and inpatient (3) adverse events; (4) blood transfusion; and (5) mortality after lower extremity fractures.
methodsUsing the National Hospital Discharge Survey database, we analyzed a total estimated number of 10,669,449 patients with lower limb fractures from 1990 to 2007. Sixty-four percent were women, and the mean±SD age was 67±22 years. The prevalence in the study population was 3.2% for depression, 1.6% for anxiety, 0.6% for schizophrenia, and 2.9% for dementia.
resultsA discharge diagnosis of psychiatric comorbidity was associated with a lower rate of discharge to home after accounting for an association with greater medical comorbidity (schizophrenia: odds ratio [OR], 5.6, 95% confidence interval [CI], 5.5-5.8; dementia: OR, 1.3, 95% CI, 1.2-1.3; depression: OR, 1.2, 95% CI, 1.2-1.3; anxiety: OR, 1.04, 95% CI, 1.02-1.06). Hospital stay was longer for patients with schizophrenia and dementia but shorter in patients with depression or anxiety compared with patients without any mental disorders. Schizophrenia was associated with more in-hospital adverse events and depression and anxiety with fewer events. A diagnosis of depression was associated with blood transfusion. Psychiatric comorbidity was not associated with a higher risk of in-hospital death.
conclusionsOptimal inpatient management of patients with lower extremity fractures should account for the influence of psychiatric comorbidities, dementia and schizophrenia in particular.
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