Patients with depression are less likely to go home after critical limb revascularization

• Published in: Journal of vascular surgery 2021-07, Vol.74 (1), p.178-186.e2
• Main Authors: Ramirez, Joel L., Zahner, Greg J., Arya, Shipra, Grenon, S. Marlene, Gasper, Warren J., Sosa, Julie Ann, Conte, Michael S., Iannuzzi, James C.
• Format: Article
• Language: English
• Subjects: Chronic limb threatening limb ischemia; Critical limb ischemia; Depression; Nonhome discharge; Peripheral artery disease
• ISSN: 0741-5214; 1097-6809
• DOI: 10.1016/j.jvs.2020.12.079

Although often overlooked during the preoperative evaluation, recent evidence has suggested that depression in patients with peripheral artery disease is associated with increased postoperative complications, including decreased primary and secondary patency after revascularization and an increased risk of major amputation and mortality. Postoperative nonhome discharge (NHD) is an important outcome for patients and has also been associated with other adverse outcomes; however, the effect that depression has on NHD after vascular surgery has remained unexplored. We hypothesized that depression would be associated with an increased risk of NHD after revascularization for chronic limb threatening ischemia (CLTI). Endovascular, open, and hybrid (combined open and endovascular) cases of revascularization for CLTI were identified from the 2012 to 2014 National (Nationwide) Inpatient Sample. CLTI, diagnoses of depression, and medical comorbidities were defined using the corresponding International Classification of Diseases, Ninth Revision, Clinical Modification codes. A hierarchical multivariable binary logistic regression controlling for hospital level variation and for confounders meeting P