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既往焦虑和抑郁对30岁及以下股骨髋臼撞击综合征患者髋关节镜术后结局的影响。

Effects of Preexisting Anxiety and Depression on Postoperative Outcomes in Patients Aged 30 Years and Younger Following Hip Arthroscopy for Femoroacetabular Impingement Syndrome.

作者信息

Johnson Andrea H, Levermore Sandra B, Maley Alyssa D, Turcotte Justin J, Petre Benjamin M

机构信息

Orthopedics, Luminis Health Anne Arundel Medical Center, Annapolis, MD, USA.

出版信息

HSS J. 2024 May;20(2):214-221. doi: 10.1177/15563316231164614. Epub 2023 Mar 31.

Abstract

Mental health influences postoperative outcomes in orthopedic procedures. Increasing attention is being paid to this effect. : We sought to evaluate the effect of diagnosed depression, anxiety, or both on postoperative outcomes in patients who have undergone hip arthroscopy for femoroacetabular impingement syndrome (FAIS). : We conducted a retrospective cohort study of 289 patients aged 30 years or younger who underwent hip arthroscopy for FAIS at a single institution from January 2014 to June 2021. Univariate statistics were used to assess differences between patients diagnosed with depression, anxiety, or both, and those without these diagnoses. Differences included demographics, operative characteristics, and postoperative outcomes: duration of postanesthesia care unit (PACU) stay, PACU pain scores, complications, reoperations, postoperative injections, 90-day emergency department (ED) visits, and patient-reported outcome measures (PROMs). Multivariate analysis was used to evaluate risk factors for postoperative complications, including wound infection, documented reinjury, postoperative intra-articular hip injection, and any reoperation. : Patients diagnosed with depression, anxiety, or both were more likely to be older, female, and have a higher comorbidity burden. At the time of surgery, they were more likely to undergo concomitant procedures, including bursectomy and iliotibial band release. Postoperatively, they had longer PACU stays (90.5 vs 75.1 minutes) and higher first PACU pain scores (5.9 vs 4.6), as well as higher rates of postoperative injection (18.1 vs 9.2%), any reoperation (13.9% vs 4.6%), and revision hip arthroscopy (11.1% vs. 3.7%). Diagnoses of depression, anxiety, or both were independently predictive of any reoperation (odds ratio [OR] = 2.841) and revision hip arthroscopy (OR = 3.401). : This retrospective cohort study found that, in patients undergoing hip arthroscopy for FAIS, there was an association between a diagnosis of depression, anxiety, or both, and increased comorbidities, higher first PACU pain scores, longer PACU stays, and increased rates of postoperative injection, any reoperation, or revision hip arthroscopy. Targeted interventions may improve outcomes, but further study is warranted.

摘要

心理健康会影响骨科手术的术后结果。这一影响正受到越来越多的关注。我们试图评估诊断为抑郁症、焦虑症或两者兼有的情况对因股骨髋臼撞击综合征(FAIS)接受髋关节镜手术患者术后结果的影响。我们对2014年1月至2021年6月在一家机构因FAIS接受髋关节镜手术的289名30岁及以下患者进行了一项回顾性队列研究。采用单变量统计评估诊断为抑郁症、焦虑症或两者兼有的患者与未诊断出这些疾病的患者之间的差异。差异包括人口统计学特征、手术特征和术后结果:麻醉后护理单元(PACU)停留时间、PACU疼痛评分、并发症、再次手术、术后注射、90天内急诊室就诊情况以及患者报告的结局指标(PROMs)。采用多变量分析评估术后并发症的危险因素,包括伤口感染、记录在案的再次受伤、术后髋关节内注射以及任何再次手术。诊断为抑郁症、焦虑症或两者兼有的患者更可能年龄较大、为女性且合并症负担较重。在手术时,他们更可能接受包括滑囊切除术和髂胫束松解术在内的联合手术。术后,他们的PACU停留时间更长(90.5分钟对75.1分钟),首次PACU疼痛评分更高(5.9对4.6),术后注射率、任何再次手术率和髋关节镜翻修率也更高(分别为18.1%对9.2%、13.9%对4.6%、11.1%对3.7%)。抑郁症、焦虑症或两者兼有的诊断独立预测任何再次手术(比值比[OR]=2.841)和髋关节镜翻修(OR=3.401)。这项回顾性队列研究发现,在因FAIS接受髋关节镜手术的患者中,抑郁症、焦虑症或两者兼有的诊断与合并症增加、首次PACU疼痛评分更高、PACU停留时间更长以及术后注射率、任何再次手术率或髋关节镜翻修率增加之间存在关联。有针对性的干预措施可能会改善结果,但仍需进一步研究。

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Depression and anxiety are associated with worse baseline function in hip arthroscopy patients.抑郁和焦虑与髋关节镜患者的基线功能较差相关。
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