AAOS Now

Published 3/25/2022
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Brandon May

Preoperative Depression, Anxiety, and ADHD Predict Complications after Carpal Tunnel Release

A history of depression, anxiety, or attention-deficit/hyperactivity disorder (ADHD) may predict complications after carpal tunnel release, according to a study to be presented at the AAOS 2022 Annual Meeting. The findings of the study will be shared by Akinade Adebayo Ojemakinde, MD, from Emory University School of Medicine in Atlanta.

The researchers examined outcomes of patients in the Truven Marketscan database who underwent surgical release for carpal tunnel syndrome from 2010 to 2017. Current Procedural Terminology ® codes were used to identify a population of 391,277 patients. Additionally, the investigators used International Classification of Disease (ICD) 9/10 codes to examine patient-level characteristics and comorbidities. Patients were categorized into cohorts based on preoperative diagnoses of depression, anxiety, and/or ADHD. Using a descriptive statistical analysis, the investigators assessed associations between depression, anxiety, and ADHD diagnoses and other comorbidities with frequently reported complications following carpal tunnel release.

Based on chi-square testing results, there were significant differences between patients with versus without depression, anxiety, or ADHD in terms of postoperative complications. In a multivariate analysis, the greatest odds of postoperative complications were associated with preoperative depression. Specifically, preoperative depression was significantly associated with opioid overdose (odds ratio [OR] = 2.54), ED visit (OR = 1.48), wound complication (OR = 1.46), sepsis (OR = 1.38), and infection (OR = 1.37) after operation.In the cohort of patients with anxiety, greater odds of postoperative pain were associated with anxiety diagnosis (OR = 1.37). Anxiety was also associated with recurrent lesion of the median nerve (OR = 1.28). Preoperative ADHD was associated with greater odds of prolonged pain (OR = 1.35) and wound-specific complications (OR = 1.40), including infection and dehiscence.

The study will be on display as Poster PO678 on Thursday and Friday in Academy Hall, from 7 a.m. to 5 p.m.

Dr. Ojemakinde’s coauthors of “Preoperative Depression, Anxiety, and Attention-deficit/Hyperactivity Disorder Predict Complications in Patients Undergoing Carpal Tunnel Release” are John Hurt, BSED; Roy Toston, BS; Alexander Dawes, BS; Anthony Karzon, MD; Michael Gottschalk, MD, FAAOS; and Eric Wagner, MD, MSc.

Brandon May is a freelance writer for AAOS Now.