Postoperative Risks in Thoracolumbar Fractures Patients with Mental Disorders: A Retrospective Cohort Study Using a Nationwide Inpatient Database.

Background: Mental disorders, such as schizophrenia and mood disorders, are associated with spine injuries. However, the relationship between mental disorders and short-term outcomes after surgery for spine injury remains unclear. This study aimed to investigate the association between mental disorders and postoperative outcomes in surgical patients with thoracolumbar fractures. Methods: This retrospective cohort study was performed using a national inpatient database in Japan. Patients who were emergently admitted and underwent spinal fixation surgery for thoracolumbar fractures were categorized into schizophrenia, mood disorder, and control groups. Postoperative outcomes included in-hospital mortality, postoperative complications, and 30-day readmission. Multivariable logistic regression analyses were performed to adjust for patient backgrounds and injury severity. Results: Among 23,148 patients, 1,243 patients had schizophrenia, 1,192 had mood disorder, and the remaining 20,713 patients were classified into the control group. In-hospital mortality was 1.0%, 0.6%, and 1.3%, postoperative complications occurred in 20.7%, 19.2%, and 18.0%, and readmission within 30 days was observed in 2.3%, 3.1%, and 3.2% of patients in the schizophrenia, mood disorder, and control groups, respectively. Compared to the control group, postoperative complications were more likely to occur in the schizophrenia group (odds ratio [OR], 1.77; 95% confidence interval [CI], 1.52-2.06) and the mood disorders group (OR, 1.50; 95% CI, 1.28-1.74). No significant differences were observed in in-hospital mortality or 30-day readmission. Conclusions: Mental disorders were associated with postoperative complications in patients with spinal injuries. Careful perioperative management may be necessary for this population.