Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Clinic for Physical Medicine and Rehabilitation, Clinical Center Serbia, Belgrade, Serbia.
Psychogeriatrics. 2014 Jun;14(2):118-23. doi: 10.1111/psyg.12049.
Depression is the most common mood disorder in elderly people and one of the most prevalent comorbidities in older people with hip fracture. While several authors have confirmed that depressive symptoms assessed at a later stage after hip fracture impact functional outcome and mortality, the role of depressive symptoms identified at an earlier stage after hip fracture remains understudied. The aim of the present study was to determine if depressive symptoms assessed on hospital admission impact early functional outcome after hip fracture surgery.
We studied 112 patients who underwent surgery for hip fracture during a 6-month period. Depressive symptoms were assessed using the 30-item Geriatric Depression Scale on admission to the acute setting. Multidimensional assessment included sociodemographic characteristics, general health status, cognitive status, functional status prior to injury, and perioperative variables. The primary outcome measure was motor Functional Independence Measure at discharge.
Adjusted multivariate regression analysis revealed that the presence of moderate to severe depressive symptoms (Geriatric Depression Scale ≥ 20), older age, and female gender were independently related to motor Functional Independence Measure at discharge.
Increasing levels of depressive symptoms in elderly hip fracture patients influence short-term functional outcome. We strongly support the introduction of routine assessment of this baseline comorbidity, especially in female patients. Failure to identify such patients is a missed opportunity for possible improvement of early functional outcome after hip fracture in elderly.
抑郁症是老年人中最常见的情绪障碍，也是老年髋部骨折患者最常见的合并症之一。虽然有几位作者已经证实，髋部骨折后晚期评估的抑郁症状会影响功能结局和死亡率，但髋部骨折后早期评估的抑郁症状的作用仍研究不足。本研究旨在确定入院时评估的抑郁症状是否会影响髋部骨折手术后的早期功能结局。
我们研究了 112 名在 6 个月期间接受髋部骨折手术的患者。入院时使用 30 项老年抑郁量表评估抑郁症状。多维评估包括社会人口统计学特征、一般健康状况、认知状态、受伤前的功能状态以及围手术期变量。主要结局测量指标为出院时的运动功能独立性测量。
调整后的多变量回归分析显示，中度至重度抑郁症状（老年抑郁量表≥20）、年龄较大和女性与出院时的运动功能独立性测量呈独立相关。
老年髋部骨折患者的抑郁症状程度增加会影响短期功能结局。我们强烈支持在常规评估这种基线合并症，尤其是在女性患者中。未能识别这些患者是改善老年髋部骨折后早期功能结局的一个错失的机会。
