抑郁症和睡眠质量对全髋关节置换术后结局的影响:一项前瞻性研究

Influence of Depression and Sleep Quality on Postoperative Outcomes after Total Hip Arthroplasty: A Prospective Study.

作者信息

Longo Umile Giuseppe, De Salvatore Sergio, Greco Alessandra, Marino Martina, Santamaria Giulia, Piergentili Ilaria, De Marinis Maria Grazia, Denaro Vincenzo

机构信息

Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Rome, Italy.

Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Rome, Italy.

出版信息

J Clin Med. 2022 Jul 2;11(13):3845. doi: 10.3390/jcm11133845.

Abstract

The trend of Total Hip Arthroplasty (THA) is projected to grow. Therefore, it has become imperative to find new measures to improve the outcomes of THA. Several studies have focused attention on the influence of psychological factors and sleep quality on surgical outcomes. The consequences of depressive states may affect outcomes and also interfere with rehabilitation. In addition, sleep quality may be an essential factor in determining surgical outcomes. To our knowledge, few articles focus on the influence of these factors on THA results. The present study investigates a possible correlation between preoperative depression or sleep quality and postoperative outcomes of THA. This study was conducted with 61 consecutive patients undergoing THA from January 2020 to January 2021. Patients were assessed preoperatively using GDS and PSQI, and six months postoperatively using FJS-12, SF-36, WOMAC, PSQI, and GDS. To simplify comparisons, the overall scores were normalized to range from 0 (worst condition) to 100 points (best condition). A total of 37 patients (60.7%) were classified as depressed and 24 as not depressed (39.3 %) in the preoperative assessment. A low-moderate positive correlation between preoperative GDS score and FJS-12 (rho = 0.22, = 0.011), SF-36-PCS (rho = 0.328, = 0.01), and SF-36-MCS (rho = 0.293, = 0.022) scores at six-month follow-up was found. When the normalized preoperative GDS score was high (no depression), the FJS-12, SF-36-PCS, and SF-36-MCS scores tended to increase more compared to the other group. Statistically significant differences between the two groups were found in postoperative FJS-12 ( = 0.001), SF-36-PCS ( = 0.017), and SF-36-MCS scores ( = 0.016). No statistically significant correlation between preoperative PSQI score and postoperative outcome measures was found. Preoperatively depressed patients had a low-moderate positive correlation with postoperative SF-36 and FJS-12 scores. There was no correlation between sleep quality and postoperative outcome measures of THA.

摘要

全髋关节置换术(THA)的趋势预计会增长。因此,寻找新的措施来改善THA的治疗效果已变得势在必行。几项研究关注了心理因素和睡眠质量对手术效果的影响。抑郁状态的后果可能会影响手术效果,还会干扰康复进程。此外,睡眠质量可能是决定手术效果的一个重要因素。据我们所知,很少有文章关注这些因素对THA结果的影响。本研究调查了术前抑郁或睡眠质量与THA术后结果之间可能存在的相关性。本研究对2020年1月至2021年1月连续接受THA的61例患者进行。术前使用老年抑郁量表(GDS)和匹兹堡睡眠质量指数(PSQI)对患者进行评估,术后6个月使用12项功能髋关节评分(FJS-12)、36项简短健康调查量表(SF-36)、西安大略和麦克马斯特大学骨关节炎指数(WOMAC)、PSQI和GDS进行评估。为了简化比较,将总体评分标准化为0(最差情况)至100分(最佳情况)。术前评估中,共有37例患者(60.7%)被归类为抑郁,24例为非抑郁(39.3%)。在术后6个月的随访中,发现术前GDS评分与FJS-12(rho = 0.22,P = 0.011)、SF-36身体功能分量表(SF-36-PCS,rho = 0.328,P = 0.01)和SF-36精神健康分量表(SF-36-MCS,rho = 0.293,P = 0.022)评分之间存在低至中度的正相关。当术前标准化GDS评分较高(无抑郁)时,与另一组相比,FJS-12、SF-36-PCS和SF-36-MCS评分的增长趋势更大。两组在术后FJS-12(P = 0.001)、SF-36-PCS(P = 0.017)和SF-36-MCS评分(P = 0.016)上存在统计学显著差异。未发现术前PSQI评分与术后结果指标之间存在统计学显著相关性。术前抑郁的患者与术后SF-36和FJS-12评分之间存在低至中度的正相关。睡眠质量与THA术后结果指标之间无相关性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4145/9267204/b82c55db0da1/jcm-11-03845-g001.jpg

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