Background

There is limited evidence exploring the relationship between mental health disorders and the readmissions following total joint arthroplasty (TJA). Therefore, we conducted a meta-analysis to evaluate the relationship between mental health disorders and the risk of readmission following TJA.

Methods

We searched PubMed, Cochrane, and Google Scholar from their inception till April 19, 2022. Studies exploring the association of mental health disorders and readmission risk following TJA were selected. The outcomes were divided into 30-day readmission, 90-day readmission, and readmission after 90 days. We also performed subgroup analyses based on the type of arthroplasty: total hip arthroplasty (THA) and total knee arthroplasty (TKA). A total of 12 studies were selected, of which 11 were included in quantitative analysis. A total of 1,345,893 patients were evaluated, of which 73,953 patients suffered from mental health disorders.

Results

The risk of 30-day readmission (odds ratio = 1.43, 95% CI 1.14-1.80, P = .002, I² = 87%) and 90-day readmission (OR = 1.35, 95% CI 1.22-1.49, P < .00001, I² = 89%) was significantly associated with mental health disorders. On subgroup analyses, 30-day readmission was significantly associated with THA (OR = 1.29, 95% CI 1.04-1.60, P = .02), but not with TKA (OR = 1.44, 95% CI 0.51-4.06, P = .50). Similarly, 90-day readmission was significantly associated with both THA (OR = 1.21, 95% CI 1.14-1.29, P < .00001) and TKA (OR = 1.33, 95% CI 1.17-1.51, P < .0001).

Conclusion

Mental health disorders are significantly associated with increased 30-day and 90-day readmissions. Increasing awareness regarding mental health disorders and readmission in arthroplasty will help in efficient preoperative risk stratification and better postoperative management in these patients.

中文翻译：

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全关节置换术后心理健康障碍与再入院的关系：一项系统评价和荟萃分析

背景

探索精神健康障碍与全关节置换术 (TJA) 后再入院之间关系的证据有限。因此，我们进行了一项荟萃分析，以评估心理健康障碍与 TJA 后再入院风险之间的关系。

方法

我们搜索了 PubMed、Cochrane 和 Google Scholar，从它们成立到 2022 年 4 月 19 日。选择了探索 TJA 后精神健康障碍与再入院风险之间关系的研究。结局分为30天再入院、90天再入院和90天后再入院。我们还根据关节置换术的类型进行了亚组分析：全髋关节置换术 (THA) 和全膝关节置换术 (TKA)。共入选12项研究，其中11项纳入定量分析。共评估1345893名患者，其中73953名患者患有精神疾病。

结果

30 天再入院风险（比值比 = 1.43，95% CI 1.14-1.80，P  = .002，I ²  = 87%）和 90 天再入院风险（OR = 1.35，95% CI 1.22-1.49，P < .00001, I ²  = 89%) 与心理健康障碍显着相关。在亚组分析中，30 天再入院与 THA 显着相关（OR = 1.29，95% CI 1.04-1.60，P  = .02），但与 TKA 无关（OR = 1.44，95% CI 0.51-4.06，P  = . 50). 同样，90 天再入院与 THA (OR = 1.21, 95% CI 1.14-1.29, P  < .00001) 和 TKA (OR = 1.33, 95% CI 1.17-1.51, P < .0001) 显着相关。

结论

心理健康障碍与 30 天和 90 天再入院率增加显着相关。提高对精神健康障碍和关节置换术再入院的认识将有助于这些患者进行有效的术前风险分层和更好的术后管理。