PATIENTS with psychosocial risk factors, including depression and neurodevelopmental disorders, face significantly worse outcomes following emergency general surgery, according to a new analysis of over 2 million cases. The study found that such risk factors were associated with increased mortality, more frequent postoperative complications, longer hospital stays, and higher readmission rates and costs.
Using data from the 2016–2021 Nationwide Readmissions Database, researchers identified adults who underwent common emergency general surgeries such as appendectomies, cholecystectomies, and bowel resections. More than half (51.8%) had documented psychosocial risk factors based on diagnostic codes for mental, behavioral, or developmental disorders. These patients were generally younger and less likely to have private insurance.
After adjusting for relevant clinical variables, patients with psychosocial risk factors had 12% higher odds of in-hospital mortality and significantly increased odds of serious complications, including sepsis, pneumonia, and renal issues. The financial impact was also substantial: hospitalization costs rose by an average of $1,350 and patients stayed in the hospital more than half a day longer on average. The odds of being readmitted within 30 days were also 23% higher among these patients.
These findings emphasize the need for routine screening and early identification of psychosocial vulnerabilities in patients undergoing emergency procedures. While the incidence of psychosocial risk factors remained stable over the five-year study period, their impact on outcomes underscores the importance of interdisciplinary care. The authors suggest that integrating psychiatric and social support services during hospitalization could help mitigate risks and improve recovery trajectories.
As healthcare systems grapple with rising costs and a growing mental health burden, the study reinforces the connection between psychological well-being and physical recovery in high-risk surgical populations.
Reference:
Ali SS et al. Association of psychosocial risk factors on outcomes of patients undergoing emergency general surgery. Surgery. 2025:185:109542. doi: 10.1016/j.surg.2025.109542. [Online ahead of print]
