Mood, anxiety disorders may prolong hospital stay following radical cystectomy

For bladder cancer patients scheduled to undergo radical cystectomy, the presence of mood and/or anxiety disorders may lead to a longer length of hospital stay and increase the likelihood of discharge to a nonhome facility, a study reports.

The study used data from the Florida Inpatient Data File and included 4,396 bladder cancer patients who underwent radical cystectomy. Researchers examined the effect of a mood or anxiety disorder (categorized as neither, one of these, or both) on outcomes, such as inpatient mortality, nonhome discharge, in-hospital complications, and length of stay.

Of the patients, 306 (7.0 percent) had a mood disorder and 389 (8.8 percent) had an anxiety disorder. Mixed-effects logistic regression (accounting for clustering within hospitals) and negative binomial regression models showed that mood and/or anxiety disorders had no significant association with mortality and the presence/number of in-hospital complications.

However, a mood or anxiety disorder appeared to increase the likelihood of nonhome discharge (odds ratio [OR], 1.60, 95 percent confidence interval [CI], 1.20–2.14) and longer length of hospital stay (incidence rate ratio [IRR], 1.13, 95 percent CI, 1.07–1.19).

The associations were also observed among patients with both mood and anxiety disorder diagnoses (nonhome discharge: OR, 2.66, 95 percent CI, 1.61–4.38; prolonged hospital stay: IRR, 1.12, 95 percent CI, 1.01–1.24).

The findings highlight the need for interventions to address the increased odds of unfavourable perioperative outcomes among radical cystectomy patients with mood and/or anxiety disorders. However, additional research is needed to determine the underlying causes of these differences and to develop effective interventions.