Wetzel Katinka, Clauss Martin, Joeris Alexander, Kates Stephen, Morgenstern Mario
Center for Musculoskeletal Infections, University Hospital Basel, Basel, Switzerland.
Department of Orthopaedic and Trauma Surgery, University Hospital Basel, Basel, Switzerland.
Bone Jt Open. 2024 Sep 1;5(9):721-728. doi: 10.1302/2633-1462.59.BJO-2024-0072.R1.
It is well described that patients with bone and joint infections (BJIs) commonly experience significant functional impairment and disability. Published literature is lacking on the impact of BJIs on mental health. Therefore, the aim of this study was to assess health-related quality of life (HRQoL) and the impact on mental health in patients with BJIs.
The AO Trauma Infection Registry is a prospective multinational registry. In total, 229 adult patients with long-bone BJI were enrolled between 1 November 2012 and 31 August 2017 in 18 centres from ten countries. Clinical outcome data, demographic data, and details on infections and treatments were collected. Patient-reported outcomes using the 36-Item Short-Form Health Survey questionnaire (SF-36), Parker Mobility Score, and Katz Index of Independence in Activities of Daily Living were assessed at one, six, and 12 months. The SF-36 mental component subscales were analyzed and correlated with infection characteristics and clinical outcome.
The SF-36 physical component summary mean at baseline was 30.9 (95% CI 29.7 to 32.0). At one month, it was unchanged (30.5; 95% CI 29.5 to 31.5; p = 0.447); it had improved statistically significantly at six months (35.5; 95% CI 34.2 to 36.7; p < 0.001) and at 12 months (37.9; 95% CI 36.4 to 39.3; p < 0.001). The SF-36 mental component summary mean at baseline was 42.5 (95% CI 40.8 to 44.2). At one month, it was unchanged (43.1; 95% CI 41.4 to 44.8; p = 0.458); it had improved statistically significantly at six months (47.1; 95% CI 45.4 to 48.7; p < 0.001) and at 12 months (46.7; 95% CI 45.0 to 48.5; p < 0.001). All mental subscales had improved by the end of the study, but mental health status remained compromised in comparison with the average USA population.
BJIs considerably impact HRQoL, particularly mental health. Patients suffering from BJIs reported considerable limitations in their daily and social activities due to psychological problems. Impaired mental health may be explained by the chronic nature of BJIs, and therefore the mental wellbeing of these patients should be monitored closely.
众所周知，骨与关节感染（BJI）患者通常会出现明显的功能障碍和残疾。关于BJI对心理健康影响的已发表文献较少。因此，本研究的目的是评估BJI患者的健康相关生活质量（HRQoL）及其对心理健康的影响。
AO创伤感染登记处是一个前瞻性的跨国登记处。2012年11月1日至2017年8月31日期间，来自十个国家的18个中心共纳入了229例长骨BJI成年患者。收集了临床结局数据、人口统计学数据以及感染和治疗的详细信息。在1个月、6个月和12个月时，使用36项简短健康调查问卷（SF-36）、帕克活动能力评分和日常生活活动能力的卡茨独立指数评估患者报告的结局。对SF-36心理成分量表进行分析，并与感染特征和临床结局进行相关性分析。
基线时SF-36身体成分总分均值为30.9（95%CI 29.7至32.0）。1个月时，该值无变化（30.5；95%CI 29.5至31.5；p = 0.447）；6个月时在统计学上有显著改善（35.5；95%CI 34.2至36.7；p < 0.001），12个月时同样有显著改善（37.9；95%CI 36.4至39.3；p < 0.001）。基线时SF-36心理成分总分均值为42.5（95%CI 40.8至44.2）。1个月时，该值无变化（43.1；95%CI 41.4至44.8；p = 0.458）；6个月时在统计学上有显著改善（47.1；95%CI 45.4至48.7；p < 0.001），12个月时为（46.7；95%CI 45.0至48.5；p < 0.001）。到研究结束时，所有心理子量表均有所改善，但与美国普通人群相比，心理健康状况仍受到损害。
BJI对HRQoL有相当大的影响，尤其是对心理健康。患有BJI的患者报告称，由于心理问题，他们在日常和社交活动中存在相当大的限制。心理健康受损可能是由BJI的慢性性质所解释的，因此应密切监测这些患者的心理健康。
