• Zachary K Christian, Salah G Aoun, Olusoji Afuwape, Emmanuel Adeyemo, Umaru Barrie, Olatunde Badejo, Luke J Dosselman, Mark N Pernik, Kristen Hall, Valery Peinado Reyes, Tarek Y El Ahmadieh, Al Tamimi Mazin M Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA; Department of Orthopedic Surgery, University of, and Carlos A Bagley.
• Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
• World Neurosurg. 2020 Sep 1; 141: e888-e893.

ObjectiveThe analysis of perioperative electronic patient portal (EPP) communication may provide risk stratification and insight for complication prevention in patients with affective disorders (ADs). We aimed to understand how patterns of EPP communication in patients with AD relate to preoperative narcotic use, surgical outcomes, and readmission rates.MethodsThe records of adult patients who underwent elective spinal surgery between January 2010 and August 2017 at a single institution were retrospectively reviewed for analysis. Primary outcomes included preoperative narcotic use, the number of perioperative EPP messages sent, rates of perioperative complications, hospital length of stay, emergency department (ED) visits within 6 weeks, and readmissions within 30 days after surgery.ResultsA total of 1199 patients were included in the analysis. Patients with an AD were more likely to take narcotics before surgery (51.69% vs. 41%, P < 0.001) and to have active EPP accounts (75.36% vs. 69.75%, P = 0.014) compared with controls. They were also more likely to send postoperative messages (38.89% vs. 32.75%, P = 0.030) and tended to send more messages (0.67 vs. 0.48, P = 0.034). The AD group had higher rates of postoperative complications (8.21% vs. 3.98%, P = 0.001), ED visits (4.99% vs. 2.43%, P = 0.009), and readmissions postoperatively (2.49% vs. 1.38%, P = 0.049).ConclusionsAD patients have specific patterns of perioperative EPP communication. They are at a higher risk of postoperative complications. Addressing these concerns early may prevent more serious morbidity and avoid unnecessary ED visits and readmissions, thus reducing costs and improving patient care.Copyright © 2020 Elsevier Inc. All rights reserved.

30 keywords...

hide…