{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T00:44:26Z","timestamp":1792889066902,"version":"4.5.0"},"reference-count":28,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2021,10,15]],"date-time":"2021-10-15T00:00:00Z","timestamp":1634256000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002858","name":"china postdoctoral science foundation","doi-asserted-by":"publisher","award":["No. 2019M662791"],"award-info":[{"award-number":["No. 2019M662791"]}],"id":[{"id":"10.13039\/501100002858","id-type":"DOI","asserted-by":"publisher"}]},{"name":"dongcheng district outstanding talent nurturing program","award":["2020-dchrcpyzz-29"],"award-info":[{"award-number":["2020-dchrcpyzz-29"]}]},{"DOI":"10.13039\/501100001809","name":"national natural science foundation of china","doi-asserted-by":"publisher","award":["No. 81603638"],"award-info":[{"award-number":["No. 81603638"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"young scientist development program, dongzhimen hospital affiliated to beijing university of chinese medicine","award":["No. DZMYS-201702"],"award-info":[{"award-number":["No. DZMYS-201702"]}]},{"DOI":"10.13039\/501100012476","name":"fundamental research funds for central universities of the central south university","doi-asserted-by":"publisher","award":["No. 2019-JYB-JS-042"],"award-info":[{"award-number":["No. 2019-JYB-JS-042"]}],"id":[{"id":"10.13039\/501100012476","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Depression is associated with poorer outcomes in a wide spectrum of surgeries but the specific effects of depression in patients undergoing cervical spine surgery are unknown. This study aimed to evaluate the prevalence and impact of pre-surgical clinical depression on pain and other outcomes after surgery for cervical degenerative disc disease using a national representative database. Data of patients with cervical myelopathy and radiculopathy were extracted from the 2005\u20132014 US Nationwide Inpatient Sample (NIS) database. Included patients underwent anterior discectomy and fusion (ACDF). Acute or chronic post-surgical pain, postoperative complications, unfavorable discharge, length of stay (LOS) and hospital costs were evaluated. Totally 215,684 patients were included. Pre-surgical depression was found in 29,889 (13.86%) patients, with a prevalence nearly doubled during 2005\u20132014 in the US. Depression was independently associated with acute or chronic post-surgical pain (aOR: 1.432), unfavorable discharge (aOR: 1.311), prolonged LOS (aOR: 1.152), any complication (aOR: 1.232), respiratory complications\/pneumonia (aOR: 1.153), dysphagia (aOR: 1.105), bleeding (aOR: 1.085), infection\/sepsis (aOR: 1.529), and higher hospital costs (beta: 1080.640) compared to non-depression. No significant risk of delirium or venous thrombotic events was observed in patients with depression as compared to non-depression. Among patients receiving primary surgery, depression was independently associated with prolonged LOS (aOR: 1.150), any complication (aOR:1.233) and postoperative pain (aOR:1.927). In revision surgery, no significant associations were found for prolonged LOS, any complication or pain. In conclusion, in the US patients undergoing ACDF, pre-surgical clinical depression predicts post-surgical acute or chronic pain, a slightly prolonged LOS and the presence of any complication. Awareness of these associations may help clinicians stratify risk preoperatively and optimize patient care.<\/jats:p>","DOI":"10.1371\/journal.pone.0258517","type":"journal-article","created":{"date-parts":[[2021,10,15]],"date-time":"2021-10-15T14:14:29Z","timestamp":1634307269000},"page":"e0258517","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":24,"title":["A national snapshot of the impact of clinical depression on post-surgical pain and adverse outcomes after anterior cervical discectomy and fusion for cervical myelopathy and radiculopathy: 10-year results from the US Nationwide Inpatient Sample"],"prefix":"10.1371","volume":"16","author":[{"given":"Jiang","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin-Yu","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gui-Hua","family":"Tian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui-Jin","family":"Qiu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue-Qian","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue-Shi","family":"Di","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiao-Mei","family":"Yuan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shui-Wen","family":"Long","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Ran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Song","family":"Jia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7385-3133","authenticated-orcid":true,"given":"Hong-Cai","family":"Shang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,10,15]]},"reference":[{"key":"pone.0258517.ref001","unstructured":"WHO. World Health Organization Fact Sheet Basel, Switzerland2020. http:\/\/who.int\/news-room\/fact-sheets\/detail\/depression."},{"issue":"10161","key":"pone.0258517.ref002","doi-asserted-by":"crossref","first-page":"2299","DOI":"10.1016\/S0140-6736(18)31948-2","article-title":"Depression","volume":"392","author":"GS Malhi","year":"2018","journal-title":"Lancet (London, England)"},{"issue":"10","key":"pone.0258517.ref003","doi-asserted-by":"crossref","first-page":"2337","DOI":"10.1016\/j.arth.2019.05.035","article-title":"Depression and Anxiety Are Risk Factors for Postoperative Pain-Related Symptoms and Complications in Patients Undergoing Primary Total Knee Arthroplasty in the United States","volume":"34","author":"X Pan","year":"2019","journal-title":"The Journal of arthroplasty"},{"issue":"5","key":"pone.0258517.ref004","doi-asserted-by":"crossref","first-page":"1247","DOI":"10.1016\/j.arth.2019.12.011","article-title":"Effects of Depressive Disorders on Patients Undergoing Primary Total Knee Arthroplasty: A Matched-Control Analysis","volume":"35","author":"RM Vakharia","year":"2020","journal-title":"The Journal of arthroplasty"},{"issue":"2","key":"pone.0258517.ref005","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/j.arth.2014.08.034","article-title":"The influence of psychiatric comorbidity on perioperative outcomes following primary total hip and knee arthroplasty; a 17-year analysis of the National Hospital Discharge Survey database","volume":"30","author":"LT Buller","year":"2015","journal-title":"The Journal of arthroplasty"},{"issue":"6","key":"pone.0258517.ref006","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1302\/0301-620X.98B6.37208","article-title":"The influence of a history of clinical depression on peri-operative outcomes in elective total shoulder arthroplasty: a ten-year national analysis","volume":"98-b","author":"B Mollon","year":"2016","journal-title":"The bone & joint 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