Study: Preop mental health assessment improves postop outcomes for older patients

Editor's Note

Preoperative mental health assessment significantly increases the odds of a postoperative “textbook outcome” for older patients, according to research published on March 15 in the journal Surgery. The median age for the patient population analyzed at the time of surgery was 74 years.

Focusing on more than 32,500 Medicare beneficiaries who underwent a major surgical procedure between 2016 and 2021, the study found that those who had a mental health evaluation in the 6 months prior to surgery were significantly more likely to experience a textbook outcome—defined as a complication-free recovery without extended hospitalization, readmission, or death within 90 days. In the scope of the study, “major surgery included coronary artery bypass grafting, abdominal aortic aneurysm repair, pneumonectomy, pancreatectomy, and colectomy.”

“Mental health assessment was defined as any encounter with a mental health professional or a claim involving a mental health Current Procedural Terminology code,” the authors noted. Only 4.6% of patients in the study had a preoperative mental health assessment, yet those who did saw improved outcomes across the board. Their rates of complications, prolonged hospital stays, 90-day mortality, and readmission were all significantly lower than those who did not receive an assessment. On multivariable analysis, mental health assessment was independently associated with a 25% greater likelihood of achieving a textbook outcome.

“Preoperative care coordination among mental health professionals and surgical care teams is critical to achieve optimal patient outcomes,” the authors concluded.