Effects of Mental Health on 30-Day Postoperative Outcomes Following Peripheral Nerve Repair

Abstract

Background:

Peripheral nerve injuries (PNIs) are a significant cause of global disability, often leading to lifelong sensory and motor deficits. Increasing efforts to unveil the psychosocial implications of such injuries is being made. The aim of this study was to determine the impact of preoperatively diagnosed mental health disorder (MHD), specifically major depressive disorder (MDD), generalized anxiety disorder (GAD), and post-traumatic stress disorder (PTSD), on short-term outcomes following PNI repair.

Methods:

A large, retrospective cohort, using the TriNetX Collaborative Global Network database queried on April 9, 2025, was used to identify patients undergoing PNI repair with preoperative MHD diagnoses. Propensity matching was performed, allowing analysis of 30-day and 90-day postoperative outcomes in patients with MHD along with subgroup analysis of those diagnosed with MDD, GAD, or PTSD.

Results:

Mental health disorder (n = 2521), MDD (n = 1107), GAD (n = 996), and PTSD (n = 938) groups were found to have increased emergency department use and hospital readmission postoperatively. Patients with MHD were less likely to attend outpatient follow-up in clinic or use occupational therapy services. Complications and opioid consumptions were similar among all groups.

Conclusions:

Following PNI repair, patients with pre-existing MHD demonstrated increased hospital resource utilization and decreased outpatient follow-up despite similar complication and opioid use rates. The need for a comprehensive, multifaceted approach to optimize treatment outcomes following PNI, specifically those with concomitant MHD, is obviated by the findings in this study.