Orthopedic Surgical Outcomes in Patients with Schizophrenia, Bipolar Disorder, and other Severe Psychiatric Illnesses: A Scoping Review
Location
LSUHSC-NO
Publication Date
April 2026
Start Date
9-4-2026 10:00 AM
End Date
9-4-2026 2:00 PM
Description
Purpose: Severe psychiatric illnesses may increase perioperative risk and complicate care pathways after orthopedic surgery, but the evidence base has not been clearly mapped. Individuals with severe psychiatric illness often experience increased medical comorbidity burden, challenges with communication and pain perception, and barriers to care that may influence surgical outcomes and recovery. This scoping review aims to identify and characterize studies reporting intrahospital events, operative complications, and postoperative complications among adults with schizophrenia, bipolar disorder, or other severe psychiatric illnesses undergoing orthopedic surgical procedures. We hypothesized the literature would be limited, dispersed, and methodologically heterogeneous.
Methods: A scoping review was performed using prespecified eligibility criteria. Eligible studies were peer-reviewed and included adults (≥18 years) undergoing orthopedic surgical procedures with schizophrenia, bipolar disorder, or other severe psychiatric illnesses. Study designs included case studies, randomized trials, qualitative studies, and secondary evidence syntheses. Searches were conducted across Cochrane, Embase, Psyclnfo, PubMed, Web of Science, and citation searching. References were imported into Covidence for title/abstract screening and full-text eligibility assessment.
Results/Conclusion: A total of 8,457 references were imported. Duplicates included 18 identified manually and 2,525 identified by Covidence, leaving 5,914 studies screened at title/abstract. Of these, 5,635 were excluded as irrelevant at the title/abstract stage. Preliminary screening suggests the evidence directly addressing schizophrenia, bipolar disorder, and severe psychiatric illnesses is scarce and scattered (279/5,914 advancing to full text, with 114 meeting inclusion criteria), indicating a meaningful gap in perioperative outcomes reporting for this population. This gap is significant given the known disparities in surgical outcomes among patients with severe psychiatric illness and the importance of integrated psychiatric surgical care models in improving perioperative care. Completion of full-text review will define injury/procedure coverage, complication domains reported, and where comparative risk estimates exist versus where the literature is effectively absent, informing priorities for risk counseling, perioperative planning, and multidisciplinary psychiatric involvement.
Recommended Citation
Dickson, Callie; Piedy, Erik; Duffy, Sharon; Poe, Lindsey MD; and Moore, Michelle MD, "Orthopedic Surgical Outcomes in Patients with Schizophrenia, Bipolar Disorder, and other Severe Psychiatric Illnesses: A Scoping Review" (2026). Dept. of Psychiatry Research Symposium. 33.
https://digitalscholar.lsuhsc.edu/psych_rd/2026/posters/33
Orthopedic Surgical Outcomes in Patients with Schizophrenia, Bipolar Disorder, and other Severe Psychiatric Illnesses: A Scoping Review
LSUHSC-NO
Purpose: Severe psychiatric illnesses may increase perioperative risk and complicate care pathways after orthopedic surgery, but the evidence base has not been clearly mapped. Individuals with severe psychiatric illness often experience increased medical comorbidity burden, challenges with communication and pain perception, and barriers to care that may influence surgical outcomes and recovery. This scoping review aims to identify and characterize studies reporting intrahospital events, operative complications, and postoperative complications among adults with schizophrenia, bipolar disorder, or other severe psychiatric illnesses undergoing orthopedic surgical procedures. We hypothesized the literature would be limited, dispersed, and methodologically heterogeneous.
Methods: A scoping review was performed using prespecified eligibility criteria. Eligible studies were peer-reviewed and included adults (≥18 years) undergoing orthopedic surgical procedures with schizophrenia, bipolar disorder, or other severe psychiatric illnesses. Study designs included case studies, randomized trials, qualitative studies, and secondary evidence syntheses. Searches were conducted across Cochrane, Embase, Psyclnfo, PubMed, Web of Science, and citation searching. References were imported into Covidence for title/abstract screening and full-text eligibility assessment.
Results/Conclusion: A total of 8,457 references were imported. Duplicates included 18 identified manually and 2,525 identified by Covidence, leaving 5,914 studies screened at title/abstract. Of these, 5,635 were excluded as irrelevant at the title/abstract stage. Preliminary screening suggests the evidence directly addressing schizophrenia, bipolar disorder, and severe psychiatric illnesses is scarce and scattered (279/5,914 advancing to full text, with 114 meeting inclusion criteria), indicating a meaningful gap in perioperative outcomes reporting for this population. This gap is significant given the known disparities in surgical outcomes among patients with severe psychiatric illness and the importance of integrated psychiatric surgical care models in improving perioperative care. Completion of full-text review will define injury/procedure coverage, complication domains reported, and where comparative risk estimates exist versus where the literature is effectively absent, informing priorities for risk counseling, perioperative planning, and multidisciplinary psychiatric involvement.