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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 2 of 2 Research Studies DisplayedGuglielminotti J, Li G
Exposure to general anesthesia for cesarean delivery and odds of severe postpartum depression requiring hospitalization.
This retrospective cohort study evaluated the risk of general anesthesia use in cesarean delivery versus neuraxial anesthesia on maternal mental health. Cesarean deliveries performed in New York State hospitals between 2006 and 2013 were included. Exclusion criteria included having more than 1 cesarean delivery during the study period, residing outside of New York State, and having a general anesthetic for other surgery or delivery in the year before or after the index case. The primary outcome looked at was severe postpartum depression (PPD), and secondary outcomes were suicidal ideation, anxiety disorders, and posttraumatic stress disorder (PTSD). The majority of cesareans used neuraxial anesthesia and only 8% (34,356) had general anesthesia. Severe PPD requiring hospitalization occurred in 1158 women with 60% identified during readmission. General anesthesia was found to be associated with a 54% increased odds of PPD, and a 91% increased odds of suicidal ideation or self-inflicted injury. There was insufficient evidence for increased risk of anxiety orders.
AHRQ-funded; HS025787.
Citation: Guglielminotti J, Li G .
Exposure to general anesthesia for cesarean delivery and odds of severe postpartum depression requiring hospitalization.
Anesth Analg 2020 Nov;131(5):1421-29. doi: 10.1213/ane.0000000000004663..
Keywords: Labor and Delivery, Pregnancy, Women, Depression, Behavioral Health, Surgery, Risk, Hospitalization, Medication, Adverse Drug Events (ADE), Adverse Events
Parthipan A, Banerjee I, Humphreys K
Predicting inadequate postoperative pain management in depressed patients: a machine learning approach.
Researchers employed a machine-learning approach to identify patients who were prescribed a combination of selective serotonin reuptake inhibitors (SSRIs) and prodrug opioids in order to examine the effect of this combination on postoperative pain control. They identified patients who received surgery over a 9-year period by using EHR data from an academic medical center, then developed and validated natural language processing (NLP) algorithms to extract depression-related information from both structured and unstructured data elements. The machine-learning algorithm accurately predicted the increase or decrease of the discharge, 3-week, and 8-week follow-up pain scores when compared to the pre-operative pain score; pre-operative pain, surgery type, and opioid tolerance were the strongest predictors of postoperative pain control. The researchers conclude that their study results provide the first direct clinical evidence that the known ability of SSRIs to inhibit prodrug opioid effectiveness is associated with worse pain control among depressed patients. They suggest that prescribers might choose direct acting opioids such as oxycodone or morphine for depressed patients on SSRIs instead of prodrug opioids.
AHRQ-funded; HS024096.
Citation: Parthipan A, Banerjee I, Humphreys K .
Predicting inadequate postoperative pain management in depressed patients: a machine learning approach.
PLoS One 2019 Feb 6;14(2):e0210575. doi: 10.1371/journal.pone.0210575..
Keywords: Care Management, Depression, Medication, Opioids, Pain, Surgery