Examining the relationship between severe persistent mental illness and surgical outcomes in women undergoing mastectomy for breast cancer - 17/06/23
, Archis Bhandarkar b, c, William V Bobo d, Mohamad Bydon c, e, Shehzad Niazi d, Sarah McLaughlin fAbstract |
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.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Severe persistent mental illness portends worse outcomes in breast cancer patients. |
• | SPMI is associated with longer hospitalization after mastectomy. |
• | SPMI is associated with more bilateral mastectomies and less breast reconstruction. |
• | SPMI increases the risk of post-procedural infection and sepsis. |
• | There is increased need for standardized screening to identify patients with SPMI. |
Keywords : Severe persistent mental illness, Surgical outcomes, Mastectomy, Breast cancer
Plan
Vol 226 - N° 1
P. 4-10 - juillet 2023 Retour au numéro
Article précédent
- Using the tools we have to improve perioperative outcomes for mastectomy patients with severe persistent mental illness
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