Postoperative Complications Associated With Subsequent Mental Health Disorders

A population-based retrospective study in the Journal of the American College of Surgeons examined the association between 30-day postoperative complications and subsequent mental health disorders. Researchers included 1,165,711 adults undergoing one of 25 common operations in Ontario, Canada, from January 2007 through December 2019. Median age was 60 years, and 61.9% were female. The primary outcome was new or worsening mental health disorders within one year, with analyses adjusted for patient, provider, and procedural factors.

Overall, 5.0% developed new or worsening mental health disorders within one year. Rates were higher among patients with complications than those without (6.2% versus 4.9%; p<0.001), with an adjusted odds ratio of 1.28 (95% CI 1.24–1.32). The association was strongest at 30 days (adjusted OR 1.77; 95% CI 1.65–1.90).

At one year, an association was observed among patients without prior mental health history (adjusted OR 1.31; 95% CI 1.17–1.46), but not among those with pre-existing history. Patients with complications also had more new psychiatrist consultations (3.2% versus 1.5%) and a higher rate of new psychotropic prescriptions.

These findings support consideration of perioperative mental health surveillance, particularly following complications. However, the retrospective observational design cannot establish causality or determine whether surveillance would improve outcomes.