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Purpose <p>Mental health disorders (MHD) represent a growing concern in the pediatric population. This study aims to evaluate whether the presence of a mental health disorder influences perioperative and postoperative outcomes in patients with adolescent idiopathic scoliosis (AIS) undergoing surgery.</p> Methods <p>Using the TriNetX collaborative network, a retrospective cohort study was conducted including pediatric patients aged 18 and under who underwent surgery for AIS. Patients were divided based on the presence or absence of a preoperative DSM-5 psychiatric diagnosis. 1:1 propensity score matching was applied to balance covariates. Statistical analyses on primary outcomes were performed.</p> Results <p>PSM included 913 patients per cohort. MHD patients had higher odds of wound dehiscence at 3&#xa0;months (OR 1.92; 95% CI 1.08–3.43), 6&#xa0;months (OR 1.93; 95% CI 1.10–3.39), 1&#xa0;year (OR 1.85; 95% CI 1.07–3.17), and 2&#xa0;years (OR 1.74; 95% CI 1.04–2.91). They also had increased risk of implant mechanical breakdown at 1&#xa0;year (OR 2.65; 95% CI 1.27–5.52) and 2&#xa0;years (OR 2.41; 95% CI 1.28–4.53). Similarly, they also had higher readmission at 3&#xa0;months (OR 1.45; 95% CI 1.03–2.04), and ED visits at 2&#xa0;years (OR 1.31; 95% CI 1.03–1.66). Following Holm–Bonferroni correction, the only outcome that remained significant was mechanical breakdown at 1&#xa0;year (OR 2.65; 95% CI 1.27–5.52; <i>p</i> = 0.049) and 2&#xa0;years (OR 2.41; 95% CI 1.28–4.53; <i>p</i> = 0.035).</p> Conclusions <p>Mental health disorders in AIS patients were associated with higher rates of postoperative complications, with only mechanical failure remaining significant after correction. These findings suggest that preoperative mental health disorders may be an important factor in recovery and surgical outcomes. Further research is needed to better understand these associations and to develop targeted perioperative strategies to optimize care for this population.</p>

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Impact of preoperative mental health disorders on postoperative outcomes in patients with adolescent idiopathic scoliosis undergoing surgery

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月26日

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  • Emily K. Vallee,
  • Ellen Lutnick,
  • Alexander Yunke,
  • Maxwell M. Scott,
  • Gabrielle A. Orie,
  • Lauren Harte,
  • Allison S. Binkley,
  • Michael R. Ferrick,
  • Jeremy P. Doak

摘要

Purpose

Mental health disorders (MHD) represent a growing concern in the pediatric population. This study aims to evaluate whether the presence of a mental health disorder influences perioperative and postoperative outcomes in patients with adolescent idiopathic scoliosis (AIS) undergoing surgery.

Methods

Using the TriNetX collaborative network, a retrospective cohort study was conducted including pediatric patients aged 18 and under who underwent surgery for AIS. Patients were divided based on the presence or absence of a preoperative DSM-5 psychiatric diagnosis. 1:1 propensity score matching was applied to balance covariates. Statistical analyses on primary outcomes were performed.

Results

PSM included 913 patients per cohort. MHD patients had higher odds of wound dehiscence at 3 months (OR 1.92; 95% CI 1.08–3.43), 6 months (OR 1.93; 95% CI 1.10–3.39), 1 year (OR 1.85; 95% CI 1.07–3.17), and 2 years (OR 1.74; 95% CI 1.04–2.91). They also had increased risk of implant mechanical breakdown at 1 year (OR 2.65; 95% CI 1.27–5.52) and 2 years (OR 2.41; 95% CI 1.28–4.53). Similarly, they also had higher readmission at 3 months (OR 1.45; 95% CI 1.03–2.04), and ED visits at 2 years (OR 1.31; 95% CI 1.03–1.66). Following Holm–Bonferroni correction, the only outcome that remained significant was mechanical breakdown at 1 year (OR 2.65; 95% CI 1.27–5.52; p = 0.049) and 2 years (OR 2.41; 95% CI 1.28–4.53; p = 0.035).

Conclusions

Mental health disorders in AIS patients were associated with higher rates of postoperative complications, with only mechanical failure remaining significant after correction. These findings suggest that preoperative mental health disorders may be an important factor in recovery and surgical outcomes. Further research is needed to better understand these associations and to develop targeted perioperative strategies to optimize care for this population.