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髋部骨折患者疼痛强度与抑郁状态的相关性:一项观察性研究。

Association between pain intensity and depressive status in patients with hip fracture: An observational study.

机构信息

College of Acupuncture-Moxibustion and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, China.

Shandong Provincial Hospital of Traditional Chinese Medicine, Jinan, China.

出版信息

Medicine (Baltimore). 2024 Aug 2;103(31):e39141. doi: 10.1097/MD.0000000000039141.

Abstract

Identifying depression symptoms in patients with hip fractures and studying the relationship between depression and pain intensity and pain location in hip fracture patients is of great significance for disease recovery in hip fracture patients. This cohort study analyzed 5 wave data from the China Health and Retirement Longitudinal Study in 2011, 2013, 2015, 2018, and 2020, focusing on 1222 patients with hip fractures. The study utilized the CESD-10 Depression Scale to assess depressive symptoms in hip fracture patients and conducted analyses to explore the relationship between depression symptoms, pain, and pain intensity, including binary logistic regression and examination of interaction terms between pain variables and pain intensity in key body parts. Depression symptoms are strongly associated with pain intensity in hip fracture patients, particularly in key body areas. Severe pain significantly increases the risk of depressive symptoms. Moreover, absence of pain in other key body parts is linked to depressive symptoms. Multivariate analysis reveals that higher education levels, marriage, urban residence, and self-rated good health serve as protective factors against depression, while diabetes and heart disease pose significant risks for depressive symptoms in hip fracture patients. Hip fracture pain can induce discomfort and trigger depressive symptoms, showing varied trajectories among patients. Pain intensity predicts the course of depressive symptoms, emphasizing the importance of tailored pain management strategies including medication, physical therapy, and nonpharmacological interventions. Personalized rehabilitation and mental health plans should be designed based on individual patient needs and differences.

摘要

识别髋部骨折患者的抑郁症状,并研究髋部骨折患者的抑郁症状与疼痛强度和疼痛部位之间的关系,对于髋部骨折患者的疾病康复具有重要意义。本队列研究分析了 2011 年、2013 年、2015 年、2018 年和 2020 年中国健康与退休纵向研究的 5 波数据,重点关注了 1222 例髋部骨折患者。该研究采用 CESD-10 抑郁量表评估髋部骨折患者的抑郁症状,并进行分析以探讨抑郁症状、疼痛与疼痛强度之间的关系,包括二元逻辑回归和检查疼痛变量与关键身体部位疼痛强度之间的交互项。髋部骨折患者的抑郁症状与疼痛强度密切相关,特别是在关键身体区域。严重的疼痛显著增加了抑郁症状的风险。此外,其他关键身体部位没有疼痛也与抑郁症状有关。多变量分析表明,较高的教育水平、婚姻、城市居住和自我评估的良好健康状况是预防抑郁的保护因素,而糖尿病和心脏病是髋部骨折患者抑郁症状的显著风险因素。髋部骨折疼痛会引起不适并引发抑郁症状,患者之间表现出不同的轨迹。疼痛强度预测抑郁症状的进程,强调了制定针对疼痛管理策略的重要性,包括药物治疗、物理治疗和非药物干预。应根据患者个体需求和差异制定个性化的康复和心理健康计划。

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