Examining the relationship between severe persistent mental illness and surgical outcomes in women undergoing mastectomy for breast cancer.

Humans Female Mastectomy Breast Neoplasms / surgery Mental Disorders / complications Mammaplasty Chronic Disease Treatment Outcome
Breast cancer Mastectomy Severe persistent mental illness Surgical outcomes

Journal

American journal of surgery
ISSN: 1879-1883
Titre abrégé: Am J Surg
Pays: United States
ID NLM: 0370473

Informations de publication

Date de publication:
07 2023
Historique:
received: 30 10 2022
revised: 12 12 2022
accepted: 26 12 2022
medline: 21 6 2023
pubmed: 2 1 2023
entrez: 1 1 2023
Statut: ppublish

Résumé

Severe persistent mental illness (SPMI) is associated with worse outcomes in cancer patients. Less is known about the relationship between SPMI and surgical outcomes after mastectomy for breast cancer. We selected patients with breast cancer and SPMI from the National Inpatient Sample (2016-2018) and used propensity score matching. We then used multivariate analysis, Kruskal-Wallis tests, and conditional logistic regression to compare demographics and outcomes. The study sample consisted of 670 patients: 536 without SPMI and 134 with SPMI. SPMI was associated with bilateral mastectomy (bilateral: 53% vs. unilateral: 42.7%, p = 0.033) and decreased frequency of breast reconstruction (p < 0.001). SPMI was associated with more extended hospitalization (4 days vs. 2 days, p < 0.001) and increased risk of developing post-procedural infection and sepsis (OR 2.909). SPMI is associated with bilateral mastectomy, more extended hospitalization, and increased risk for post-procedural infection and sepsis - suggesting the need for increased use of standardized screening tools to identify SPMI in patients and inform perioperative management correctly.

Sections du résumé

BACKGROUND
Severe persistent mental illness (SPMI) is associated with worse outcomes in cancer patients. Less is known about the relationship between SPMI and surgical outcomes after mastectomy for breast cancer.
METHODS
We selected patients with breast cancer and SPMI from the National Inpatient Sample (2016-2018) and used propensity score matching. We then used multivariate analysis, Kruskal-Wallis tests, and conditional logistic regression to compare demographics and outcomes.
RESULTS
The study sample consisted of 670 patients: 536 without SPMI and 134 with SPMI. SPMI was associated with bilateral mastectomy (bilateral: 53% vs. unilateral: 42.7%, p = 0.033) and decreased frequency of breast reconstruction (p < 0.001). SPMI was associated with more extended hospitalization (4 days vs. 2 days, p < 0.001) and increased risk of developing post-procedural infection and sepsis (OR 2.909).
CONCLUSIONS
SPMI is associated with bilateral mastectomy, more extended hospitalization, and increased risk for post-procedural infection and sepsis - suggesting the need for increased use of standardized screening tools to identify SPMI in patients and inform perioperative management correctly.

Identifiants

DOI: 10.1016/j.amjsurg.2022.12.019 PMID: 36588017
pubmed: 36588017
pii: S0002-9610(22)00827-3
doi: 10.1016/j.amjsurg.2022.12.019
pii:
doi:

Types de publication

Journal Article Comment

Langues

eng

Sous-ensembles de citation

IM

Pagination

4-10

Commentaires et corrections

Type : CommentOn
Type : CommentIn
Type : CommentIn

Informations de copyright

Published by Elsevier Inc.

Déclaration de conflit d'intérêts

Declaration of competing interest All authors declare that they have no conflicts of interest.

Auteurs

Anagha J Deshpande (AJ)

Mayo Clinic Alix School of Medicine, Scottsdale, AZ, USA. Electronic address: Deshpande.anagha@mayo.edu.

Archis Bhandarkar (A)

Mayo Clinic Alix School of Medicine, Rochester, MN, USA; Mayo Clinic Neuro-Informatics Laboratory, Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA.

William V Bobo (WV)

Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL, USA.

Mohamad Bydon (M)

Mayo Clinic Neuro-Informatics Laboratory, Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA; Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA.

Shehzad Niazi (S)

Department of Psychiatry and Psychology, Mayo Clinic, Jacksonville, FL, USA.

Sarah McLaughlin (S)

Department of Surgery, Mayo Clinic, Jacksonville, FL, USA.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Examining the relationship between severe...
questionsmedicales.fr › Procédures de chirurgie opératoire › Mastectomie › Examining the relationship between severe...
questionsmedicales.fr › Maladies de la peau et du tissu conjonctif › Maladies de la peau › Maladies du sein › Tumeurs du sein › Examining the relationship between severe...
questionsmedicales.fr › Troubles mentaux › Examining the relationship between severe...
questionsmedicales.fr › Procédures de chirurgie opératoire › Procédures de chirurgie reconstructive › Mammoplastie › Examining the relationship between severe...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Caractéristiques de la maladie › Maladie chronique › Examining the relationship between severe...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Mécanismes d'évaluation des soins de santé › Évaluation des résultats et des processus en soins de santé › Évaluation de résultat (soins) › Résultat thérapeutique › Examining the relationship between severe...