Perioperative complications of emergent and elective procedures in psychiatric patients

Patients with psychiatric disorders have an increased risk for morbidity and mortality from other medical conditions. Medical records of all the patients undergoing appendectomy (n = 2594) and laparoscopic cholecystectomy (n = 2874) from 2009 to 2014 in one hospital were reviewed. For each patient with a documented psychiatric disorder undergoing surgery, four controls were matched. The final sample of patients undergoing appendectomy included 96 patients, whereas those undergoing laparoscopic cholecystectomy included 260 patients. In the emergent scenario, psychiatric patients had longer time from symptom appearance to admission, longer hospitalization duration, and increased rate and severity of postoperative complications. In the elective scenario, psychiatric patients were shown to have more postoperative respiratory complications. Our results, together with the high prevalence of psychiatric disorders in the population, underscore the importance of screening for psychiatric disorders and their proper documentation in surgical patients.