Adverse effect of depression on surgical outcome of artificial femoral head replacement in elderly patients

doi:10.3877/cma.j.issn.1674-134X.2020.03.005

Abstract

Abstract:

Objective

To investigate the effect of depression on surgical outcome of femoral head replacement in elderly patients with femoral neck fracture.

Methods

Between January 2015 and January 2019 in Beijing Hospital, artificial femoral head replacement was performed in 434 elderly patients with femoral neck fracture that were enrolled in the study. There were 133 males and 301 females with an average age of (75.0±4.4)years. Pathological fracture and cognitive impairment were excluded.All patients were divided into depression group (226 cases) and non-depressed group (208 cases) by geriatric depression scale (GDS). The Harris hip joint scoreand visual analogue scale (VAS) were compared after three months and 12 months postoperatively. The data were analyzed by chi-square test, t test and repeated measure ANOVA.

Results

There was no statistically significant difference between the two groups in demographic data. The patients with preoperative depression showed poorer improvement than non-depressed patients in the surgery outcome: Harris scores improved (73±3) versus(85±5)at three months(t=29.614, P<0.001), and (82±4) versus (93±4) at 12 months(t=32.252, P<0.001). VAS scores increased at 12 months (2.7±0.7) versus (0.7±0.4)(t=35.739, P<0.001).

Conclusion

Preoperative depression has adverse effects on functional recovery and pain relief after artificial femoral head replacement in elderly patients.

Key words: Aged, Hemiarthroplasty, Hip, Femoral neck fracture, Depression

Chi Liu, Lei Shi, Jing He, Yaonan Zhang, Lin Wang, Nan Min, Qingyun Xue. Adverse effect of depression on surgical outcome of artificial femoral head replacement in elderly patients[J]. Chinese Journal of Joint Surgery(Electronic Edition), 2020, 14(03): 286-290.

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References 22

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组别	例数	年龄[岁，(±s)]	性别(男/女)	婚姻状况(配偶无/有)	居住状况(独居/非独居)	教育程度[年，(±s)]	吸烟情况(是/否)	慢性疾病病史(有/无)
非抑郁组	203	75.6±4.2	57/146	63/140	60/143	11.7±1.7	45/158	132/71
抑郁组	223	75.8±3.5	65/158	74/149	76/147	11.5±2.9	47/176	150/73
统计值	?	t＝0.564	χ²＝0.059	χ²＝0.225	χ²＝1.001	t＝0.931	χ²＝0.075	χ²＝0.238
P值	?	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05

组别	例数	年龄[岁，(±s)]	性别(男/女)	婚姻状况(配偶无/有)	居住状况(独居/非独居)	教育程度[年，(±s)]	吸烟情况(是/否)	慢性疾病病史(有/无)
非抑郁组	203	75.6±4.2	57/146	63/140	60/143	11.7±1.7	45/158	132/71
抑郁组	223	75.8±3.5	65/158	74/149	76/147	11.5±2.9	47/176	150/73
统计值	?	t＝0.564	χ²＝0.059	χ²＝0.225	χ²＝1.001	t＝0.931	χ²＝0.075	χ²＝0.238
P值	?	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05	>0.05

组别	例数	术后3月Harris评分	术后12月Harris评分	术后住院时间(d)	住院费用(元)
非抑郁组	203	85±5	93±4	9±5	65 219±9 370
抑郁组	223	73±3	82±4	10±9	76 261±23 327
t值	?	29.614	32.252	1.972	6.297
P值	?	<0.001	<0.001	<0.05	<0.001

组别	例数	术后3月Harris评分	术后12月Harris评分	术后住院时间(d)	住院费用(元)
非抑郁组	203	85±5	93±4	9±5	65 219±9 370
抑郁组	223	73±3	82±4	10±9	76 261±23 327
t值	?	29.614	32.252	1.972	6.297
P值	?	<0.001	<0.001	<0.05	<0.001

组别	例数	术前	术后3个月	术后12个月	F值^a	P值
非抑郁组	203	7.1±1.2	2.1±1.1	0.7±0.4	2654.833	<0.001
抑郁组	223	7.1±1.0	2.0±0.9	2.7±0.7	2251.212	<0.001
t值	?	0.000	1.031	35.739	?	?
P值	?	>0.05	>0.05	<0.001	?	?

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