Depression and anxiety, peripheral blood inflammatory factors, and stress levels on therapeutic outcomes in patients with chronic wounds.

Abstract

Background: The incidence of chronic wounds is rising due to an aging population and lifestyle changes in our country. In addition, as the disease spectrum evolves, chronic wounds have become common clinical issues that seriously threaten health and impose significant social and economic burdens.

Aim: To investigate how depression, anxiety, peripheral blood inflammatory factors, and stress levels affect therapeutic outcomes in patients with chronic wounds.

Methods: Retrospectively collected clinical data from 110 patients with chronic wounds treated at Changde Hospital, Xiangya School of Medicine, Central South University (The First People's Hospital of Changde City) between January 2021 and December 2023, categorizing them into effective and ineffective groups based on treatment effects. Differences between both groups were analyzed using univariate analysis, independent risk factors identified via logistic regression, and their predictive value assessed through receiver operating characteristic analysis.

Results: Following treatment, 95 cases were classified as the effective group (cured or improved), while 15 cases with improvement formed the ineffective group. Significant differences between both groups were noted in wound area, infection status, daily bed time, Hamilton Anxiety Rating Scale (HAMA) scores, Hamilton Depression Rating Scale (HAMD) scores, and levels of interleukin-6, tumor necrosis factor-alpha, and superoxide dismutase (P < 0.05). Logistic regression analysis identified a wound area ≥ 7 cm², HAMA ≥ 9 scores, and HAMD ≥ 8 scores were independent risk factors for ineffective treatment in patients with chronic wounds (P < 0.05). The receiver operating characteristic curve analysis revealed that the area under the curve for ineffective treatment based on wound area, HAMA, and HAMD was 0.767, 0.805, and 0.768 respectively.

Conclusion: Wound size, anxiety, and depression are significant factors influencing the therapeutic outcomes in patients with chronic wounds that require careful attention, alongside the development of appropriate strategies.