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The Influence of Psychiatric Comorbidity on Inpatient Outcomes following Distal Humerus Fractures
Background: The influence of psychiatric comorbidity on outcomes following inpatient management of upper extremity fractures is poorly understood. Methods: The National Hospital Discharge Survey was queried to identify patients admitted to US hospitals with distal humerus fractures between 1990 and 2007. Patients were subdivided into 5 groups: depression, anxiety, schizophrenia, dementia, and no psychiatric comorbidity. Multivariable logistic regression analysis identified independent risk factors for adverse events, requirement of blood transfusion, and discharge to another inpatient facility. Results: A cohort representative of 526,185 patients was identified as having a distal humerus fracture. Depression, anxiety, and dementia were independently associated with higher odds of in-hospital adverse events (P < 0.001). Depression was associated with higher odds of inpatient blood transfusion (P < 0.001). Depression, schizophrenia, and dementia were associated with higher odds of nonroutine discharge to another inpatient facility (P < 0.001). Patients with a diagnosis of schizophrenia had a mean of 12 (P < 0.001) more days of care than patients with no psychiatric comorbidity. Discussion: Patients with comorbid psychiatric illness who are admitted to hospitals with distal humerus fractures are at increased risk of inpatient adverse events and posthospitalization care.
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