Effects of Psychiatric Comorbidities on the Perioperative Outcomes Following a Primary Total Arthroplasty

Abstract

This review was conducted to compare the perioperative outcomes following a total primary arthroplasty among patients with a psychiatric comorbidity versus those without a psychiatric comorbidity. Literature was reviewed from the database Pubmed. Seven cohort and case-control studies were reviewed, with the largest sample size of 8.4 million patients. Psychiatric comorbidities resulted in increased negative perioperative outcomes compared to patients without psychiatric comorbidities in six articles. These studies observed higher rates of revision, blood transfusion, mortality, non-traditional discharge, and increased length and cost of stay for patients with a diagnosed psychiatric condition. Therefore, it was concluded from most studies that patients with psychiatric comorbidities experience more negative perioperative outcomes following a total primary joint arthroplasty than those without. Based on the findings of this review, psychiatric comorbidities should be considered a risk factor when planning a primary arthroplasty. The broader impact of this study is to raise awareness about the impact of psychiatric comorbidities on perioperative outcomes, in an effort to inform practice, quantify the given issue, demonstrate its impact, and suggest ways to move forward in which we can maximize the positive perioperative outcomes of the targeted group.