Depression Prevalence in Metastatic Spine Disease Patients Undergoing Surgery

Introduction: Depression is a common comorbidity in metastatic spine disease (MSD) patients, often exacerbated by surgery. Understanding its prevalence is crucial, as it affects treatment decisions, recovery, and overall well-being. This study aims to evaluate depression rates in MSD patients undergoing surgery and examine changes throughout the surgical process.

Methods: We retrospectively analyzed electronic medical records of metastatic spine disease patients who underwent surgery at a large academic center from 2015 to 2023. Patients under 18 and those without NCCN Distress Thermometer depression data were excluded. Data on depression was collected based on patients’ "yes" responses in the problem list. Depression prevalence was assessed at baseline (nearest to surgery), 30 days post-op, and 90 days post-op. Chi-square tests analyzed associations across timepoints (p < 0.05). Descriptive data on race, sex, marital status, age, and insurance type were compared between patients with and without depression.

Results: Overall, 33.3% of MSD patients reported depression as a concern at least one time along their surgical course. At baseline, 34 out of the 197 patients 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 course. 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.