Prevalence of Depression in Metastatic Spine Disease Surgical Patients

Introduction: Depression is a common comorbidity in patients with metastatic spine disease, often worsened by surgical intervention. Understanding its prevalence is vital, as it impacts treatment decisions, recovery, and well-being. This study aims to evaluate depression rates in MSD patients undergoing surgery and assess variations throughout the surgical process.

Methods: Electronic medical records were retrospectively analyzed for metastatic spine disease patients undergoing surgical intervention at a large academic center between 2015 and 2023. Patients under 18 years old and those without National Comprehensive Cancer Network Distress Thermometer depression data were excluded. Data was collected as the number and percentage of patients that selected “yes” to depression on the problem list. The prevalence of depression was identified overall, at baseline (the closest recorded point to surgery), 30 days postop and at 90 days postop. Chi- Square tests were used to analyze associations across timepoints (p < 0.05). Descriptive data was recorded for race (white/nonwhite), sex, marital status, age and insurance (public/private) between those with depression and those without.

Results: Overall, 33.3% of MSD patients reported depression as a concern at least one time along their surgical course. 197 patients’ data was recorded at baseline and of these, 34 reported depression as a concern (17.3%). 139 patients were recorded at 30 days post-op and 128 were recorded at 90 days post-op. At these timepoints, 17.3% and 14.1% of patients reported depression on the problem list, respectively. There was no statistically significant difference in percentage of patients reporting depression across timepoints. There were also no apparent differences at any time point between groups that reported depression and those that didn’t when considering sociodemographic associations.

Conclusion : A notable portion of MSD patients experience depression throughout their surgical journey. Importantly, there were no statistically significant differences in depression rates at various timepoints and no clear sociodemographic associations, suggesting that depression may be a persistent concern for any patient. This highlights the importance of ongoing assessment and support for depression among MSD patients, regardless of their timing in the surgical process or sociodemographic profile to mitigate the potential impact of comorbid depression on postoperative recovery.