The impact of mental health on shoulder arthroplasty and rotator cuff repair: a meta-analysis.

IF 1.8 Q2 ORTHOPEDICS Clinics in Shoulder and Elbow Pub Date : 2024-09-01 Epub Date: 2024-07-30 DOI:10.5397/cise.2024.00178
Mohammad Daher, Ryan Lopez, Peter Boufadel, Oscar Covarrubias, Jack C Casey, George A Casey, Mohamad Y Fares, Joseph A Abboud
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Abstract

Background: The aim of this study was to evaluate the impact of mental health attributes, such as the presence of psychiatric comorbidities or psychological comorbidities (low resilience), on outcomes after rotator cuff repair (RCR) and total shoulder arthroplasty (TSA).

Methods: PubMed, Cochrane, and Google Scholar (results pages 1-20) were searched up to November 2023. Mental health problems of interest included the presence of psychiatric comorbidities (depression, anxiety) or indicators of poor psychological functioning, such as low resilience or the presence of distress. Patients were assigned to poor or good mental health groups in this study based on their grouping in the original study.

Results: Fourteen studies were included in the meta-analysis. Patients with good mental health had greater improvements in postoperative American Shoulder and Elbow Surgeons and Simple Shoulder Test scores in the TSA cohort (P=0.003 and P=0.01), RCR cohort (P<0.001), and the combined TSA and RCR cohort (P<0.001). No difference was found in visual analog scale score, satisfaction, external rotation, or flexion between the two mental health groups. Patients with poor mental health undergoing RCR experienced higher rates of adverse events and transfusions (P<0.001). Patients with poor mental health also had greater rates of revision and emergency department visits in the TSA cohort (P<0.001), RCR cohort (P=0.05 and P=0.03), and combined cohort (P<0.001). Patients with poor mental health undergoing TSA had a higher rate of re-admission (P<0.001).

Conclusions: Patients with poor preoperative mental health showed inferior patient-reported outcome scores and increased rates of adverse events, revisions, and re-admissions. Level of evidence: III.

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心理健康对肩关节置换术和肩袖修复术的影响:一项荟萃分析。
研究背景本研究旨在评估精神健康属性(如存在精神疾病合并症或心理合并症(低复原力))对肩袖修复术(RCR)和全肩关节置换术(TSA)术后效果的影响:方法:检索了截至 2023 年 11 月的 PubMed、Cochrane 和 Google Scholar(结果第 1-20 页)。关注的心理健康问题包括是否存在精神疾病合并症(抑郁、焦虑)或心理功能不佳的指标,如抗压能力低或存在痛苦。在本研究中,患者根据其在原始研究中的分组情况被分配到心理健康状况差或心理健康状况好的组别:荟萃分析共纳入了 14 项研究。在TSA队列(P=0.003和P=0.01)、RCR队列(PConclusions:术前心理健康状况较差的患者的患者报告结果评分较低,不良事件、翻修和再次入院的发生率较高。
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来源期刊
CiteScore
0.30
自引率
0.00%
发文量
55
审稿时长
15 weeks
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