术前抑郁症与短期并发症的增加有关,但在膝关节关节整形术中具有相当的长期结果
Orthopedics
|June 5, 2023
概括
在全膝关节整形术 (TKA) 患者的手术前抑郁症没有恶化功能或疼痛结果. 然而,抑郁症得分较高的患者在抑郁症和疼痛方面经历了更大的改善,再入院率增加.
科学领域:
- 整形外科 整形外科 整形外科
- 精神病学是一个精神病学.
- 康复医学 康复医学 康复医学
背景情况:
- 同时出现的抑郁症可能会对全膝关节整形术 (TKA) 后的结果产生负面影响.
- 患者报告结果测量信息系统 (PROMIS) 调查有效量化抑郁症,疼痛和身体功能.
- 手术前的抑郁症是TKA结果较差的潜在风险因素.
研究的目的:
- 调查手术前PROMIS抑郁症得分和TKA后的结果之间的关联.
- 为了确定更高的手术前抑郁症得分是否与TKA后的功能,疼痛或心理结果相对较差.
- 评估手术前抑郁症对疼痛管理,再入院和TKA后修订率的影响.
主要方法:
- 研究了一组258名接受初级TKA治疗的患者.
- 抑郁症,疼痛和功能的PROMIS评分是在手术前和多次术后间隔 (6周,3个月,1年,2年) 收集的.
- 患者被分为有PROMIS抑郁症 (PD,得分≥55) 和没有PROMIS抑郁症 (ND,得分<55) 的两组.
主要成果:
- 患者在PD组显示显著改善抑郁症得分在所有的随访和减少疼痛得分1年.
- 在PD和ND组之间的功能评分变化中没有观察到显著差异.
- 病发症组的再入院率高于90天 (P=.002),但两年修订率相似 (P=.648).
结论:
- 手术前的PROMIS抑郁症得分为55或以上,与手术后功能,抑郁或疼痛的负面影响无关.
- 手术前抑郁症得分较高的患者在TKA后可能会在抑郁症和疼痛方面经历更大的改善.
- 高度的手术前抑郁症与TKA后的90天再入院率增加有关,这需要进一步调查和潜在的干预.
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