创伤后应激障碍更有可能发生在接受下肢关节塑形手术的年轻患者身上:对功能和生活质量的影响
Andrew Womersley1, Nick Clement2,3, Sam Jones2
1Academic Surgical Unit, South West London Orthopaedic Elective Centre, Epsom, UK. andrew.womersley2@nhs.net.
Archives of orthopaedic and trauma surgery
|September 29, 2023
概括
创伤后应激障碍 (PTSD) 与接受关节或膝关节置换手术的患者的关节功能和生活质量降低有关. 年轻的年龄和较低的健康评分预测PTSD风险,影响恢复结果.
科学领域:
- 整形外科手术 整形外科手术
- 精神病学是一个精神病学.
- 与健康相关的生活质量
背景情况:
- 创伤后应激障碍 (PTSD) 的患病率和对接受关节整形手术 (THA) 和膝关节整形手术 (TKA) 患者的结果的影响尚未完全理解.
- 研究PTSD与关节特异性功能和与健康相关的生活质量 (HRQoL) 之间的关联对于改善患者护理至关重要.
研究的目的:
- 评估PTSD和手术前/手术后关节功能和THA和TKA患者的HRQoL之间的关联.
- 在这个患者队列中确定与PTSD相关的术前因素.
主要方法:
- 一项回顾性单中心研究分析了2年来1244名THA和1356名TKA患者的数据.
- 患者在手术前和1年后完成了牛津部/膝盖分数和EuroQoL问卷 (EQ-5D).
- 术后PTSD使用DSM-5 (PCL-5) 的PTSD检查清单进行评估,得分≥31表示临时PTSD.
主要成果:
- 3.4%的THA和4.0%的TKA患者符合临时的PTSD标准.
- 在THA和TKA组中,年龄较小与PTSD有显著的关联 (p<0.001).
- 创伤后应激障碍组在术前的牛津和EQ-5D得分较差,在术后的这些得分的改善明显较低 (p<0.001).
- 年龄和EQ-5D独立预测PTSD风险.
结论:
- 在接受THA/TKA治疗的25名患者中,大约有1名符合临时PTSD标准.
- 创伤后应激障碍与术前功能较差,HRQoL较差,以及关节特异性功能和HRQoL术后改善的减少有关.
- 年龄和EQ-5D得分可以帮助识别患有PTSD风险的患者.
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