A Pardo Pol, J Amestoy Ramos, A Fontanellas-Fes, X Lizano-Díez, A L Garcia, F Marques López
{"title":"Does depression influence the postoperative result of total hip arthroplasties?","authors":"A Pardo Pol, J Amestoy Ramos, A Fontanellas-Fes, X Lizano-Díez, A L Garcia, F Marques López","doi":"10.52628/90.1.12350","DOIUrl":null,"url":null,"abstract":"<p><p>Chronic pain and functional limitations caused by coxarthrosis are important factors in the onset of depression, as there are higher rates of depression in this group of patients than in the general population. Total hip arthroplasty (THA) has been shown to decrease pain and improve function in these patients, which may positively influence the patient's depressive symptoms. The objectives of the study are to evaluate the differences between patients with depression and patients without depression in the immediate postoperative period (pain and hospitalization time) and to evaluate functional outcomes one year after surgery. Therefore, we conducted a prospective cohort study in which all patients with indications for primary total hip arthroplasty during 2018 were included. Preoperatively, patients completed the PHQ-9 questionnaire, and were classified into patients with depression (if preoperative PHQ-9 > or = to 10) and patients without depression (pre PHQ-9 < to 10). During the hospital stay, postoperative pain was assessed by VAS, and the need for analgesic rescue with major opioids. One year after surgery, the PHQ-9 test was retaken, and functional outcomes were assessed. The results showed that both groups were comparable in terms of sex, age, BMI, and ASA. No differences were found in postoperative pain or hospitalization time. There were also no differences between the two groups of patients in functional outcomes one year after surgery. Therefore, we can conclude that patients with a diagnosis of depression do not present worse postoperative pain after THA. In addition, they show a significant improvement in their depressive symptoms one year after surgery.</p>","PeriodicalId":7018,"journal":{"name":"Acta orthopaedica Belgica","volume":null,"pages":null},"PeriodicalIF":0.5000,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta orthopaedica Belgica","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.52628/90.1.12350","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
Abstract
Chronic pain and functional limitations caused by coxarthrosis are important factors in the onset of depression, as there are higher rates of depression in this group of patients than in the general population. Total hip arthroplasty (THA) has been shown to decrease pain and improve function in these patients, which may positively influence the patient's depressive symptoms. The objectives of the study are to evaluate the differences between patients with depression and patients without depression in the immediate postoperative period (pain and hospitalization time) and to evaluate functional outcomes one year after surgery. Therefore, we conducted a prospective cohort study in which all patients with indications for primary total hip arthroplasty during 2018 were included. Preoperatively, patients completed the PHQ-9 questionnaire, and were classified into patients with depression (if preoperative PHQ-9 > or = to 10) and patients without depression (pre PHQ-9 < to 10). During the hospital stay, postoperative pain was assessed by VAS, and the need for analgesic rescue with major opioids. One year after surgery, the PHQ-9 test was retaken, and functional outcomes were assessed. The results showed that both groups were comparable in terms of sex, age, BMI, and ASA. No differences were found in postoperative pain or hospitalization time. There were also no differences between the two groups of patients in functional outcomes one year after surgery. Therefore, we can conclude that patients with a diagnosis of depression do not present worse postoperative pain after THA. In addition, they show a significant improvement in their depressive symptoms one year after surgery.
髋关节病引起的慢性疼痛和功能限制是抑郁症发病的重要因素,因为这类患者的抑郁症发病率高于普通人群。事实证明,全髋关节置换术(THA)可减轻这些患者的疼痛并改善其功能,这可能会对患者的抑郁症状产生积极影响。本研究的目的是评估抑郁症患者与非抑郁症患者在术后初期(疼痛和住院时间)的差异,并评估术后一年的功能效果。因此,我们开展了一项前瞻性队列研究,纳入了2018年期间所有具有初级全髋关节置换术适应症的患者。术前,患者填写PHQ-9问卷,分为抑郁症患者(若术前PHQ-9>或=10)和非抑郁症患者(术前PHQ-9<至10)。住院期间,通过 VAS 评估术后疼痛,以及是否需要使用主要阿片类药物进行镇痛。术后一年,再次进行PHQ-9测试,并对功能结果进行评估。结果显示,两组患者在性别、年龄、体重指数(BMI)和ASA方面具有可比性。在术后疼痛和住院时间方面没有发现差异。两组患者术后一年的功能结果也无差异。因此,我们可以得出这样的结论:被诊断患有抑郁症的患者在接受 THA 手术后不会出现更严重的术后疼痛。此外,他们的抑郁症状在术后一年也有明显改善。