The Perioperative Symptom Severity of Higher Patient Health Questionnaire-9 Scores Between Genders in Single-Level Lumbar Fusion.

Autor:	Parrish JM; Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois., Jenkins NW; Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois., Massel DH; Department of Orthopaedics, Miller School of Medicine, University of Miami, Miami, Florida., Rush AJ 3rd; Department of Orthopaedics, Miller School of Medicine, University of Miami, Miami, Florida., Parrish MS; Road Home Program, Department of Psychiatry, Rush University Medical Center, Chicago, Illinois., Hrynewycz NM; Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois., Brundage TS; Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois., Van Horn R; Road Home Program, Department of Psychiatry, Rush University Medical Center, Chicago, Illinois., Singh K; Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois.
Jazyk:	angličtina
Zdroj:	International journal of spine surgery [Int J Spine Surg] 2021 Feb; Vol. 15 (1), pp. 62-73. Date of Electronic Publication: 2021 Feb 18.
DOI:	10.14444/8007
Abstrakt:	Background: Preoperative depression is associated with increased perioperative pain, worse physical function, reduced quality of life, and inferior outcomes. Few studies have evaluated depressive symptoms between genders for individuals undergoing minimally invasive transforaminal lumbar interbody fusion (MIS TLIF). The purpose of this investigation was to assess the severity of Patient Health Questionnaire-9 (PHQ-9) scores among patients with depressive symptoms before and after single-level MIS TLIF. Methods: A prospective surgical registry was retrospectively reviewed for spine surgeries between March 2016 and December 2018. We included patients with at least mild depressive symptoms (PHQ-9 scores ≥ 5) who underwent primary, single-level MIS TLIF and compared genders using χ 2 tests and t tests. Genders were stratified by depressive symptom severity: mild (5-9), moderate (10-14), and moderately severe (≥15) and then analyzed at preoperative and postoperative intervals: 6 weeks, 12 weeks, 6 months, and 1 year. Finally, PHQ-9 scores were validated with a Pearson correlation test against the 12-item Short Form (SF-12) Mental Composite Score (MCS) and the Veterans RAND (VR-12) MCS. Results: Of 75 subjects, 44.0% were women and the mean age was 49.9 years. The preoperative distribution among PHQ-9 subgroups was 38.7%, 26.6%, and 34.7% for mild, moderate, and moderately severe depressive symptoms, respectively. Among PHQ-9 stratifications both genders demonstrated intermittent statistically significant improvements in PHQ-9 scores. The moderately severe PHQ-9 subgroup had improvement at all postoperative time points. The PHQ-9 scores demonstrated a strong correlation with the SF-12 MCS and VR-12 MCS at all postoperative evaluations. Conclusion: At baseline and by the final 1-year follow-up there were no statistically significant PHQ-9 score differences between genders within any depressive symptom stratifications. Whereas some contend that men and women have substantial mental health differences, this study is aligned with growing evidence that demonstrates similar depressive symptoms between genders. Level of Evidence: 3. Clinical Relevance: Men and women may be at an equivalent risk for perioperative depressive symptoms. (This manuscript is generously published free of charge by ISASS, the International Society for the Advancement of Spine Surgery. Copyright © 2021 ISASS.)
Databáze:	MEDLINE
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