Depression and psychotic disorders worsen perioperative outcomes and increase resource utilization after multilevel lumbar fusion: Implications for screening and perioperative care.

Context: Multilevel lumbar fusion use has increased with an aging U.S. population. Depression and psychotic disorders are linked to poorer surgical outcomes, but their effects in this setting are unclear. Aims: The aims of this study were to quantify the prevalence of these disorders and evaluate associations with perioperative outcomes and resource use. Settings and Design: This was a retrospective cohort study using the National Inpatient Sample from 2016 to 2022. Subjects and Methods: Depression and psychotic disorders were defined using Elixhauser-derived indicators. Outcomes included medical and mechanical complications, discharge disposition, length of stay (LOS), and costs. Statistical Analysis Used: Chi-square and logistic regression analyses were performed, with significance at the Results: Among 458,180 weighted admissions, 18.6% had depression and 2.5% had psychoses. Compared to patients without these diagnoses, depression was associated with higher odds of cardiovascular complications (odds ratio [OR]: 1.25, Conclusions: Depression and psychotic disorders are common among patients undergoing multilevel lumbar fusion and are associated with higher healthcare utilization.