Lappalainen Emma, Huttunen Jukka, Kokki Hannu, Toroi Petri, Kokki Merja
Institute of Clinical Medicine, University of Eastern Finland, FI-70211 Kuopio, Finland.
Department of Neurosurgery, Neuro Centre, Kuopio University Hospital, FI-70029 Kuopio, Finland.
J Clin Med. 2024 Nov 21;13(23):7007. doi: 10.3390/jcm13237007.
: Psychological factors impact patient-reported outcome measures (PROMs). This study assessed the influence of preoperative anxiety, depression, and resilience on postoperative pain interference and life satisfaction one year after spine surgery. : This study was a secondary analysis of a study involving 120 patients who underwent elective spine surgery and were randomly assigned to receive either tramadol-paracetamol (37.5 mg/325 mg; two tablets; n = 61) or placebo (n = 59) twice per day for pain management during the first five postoperative days. Patients completed the Life Satisfaction Scale-4, Brief Pain Inventory, Hospital Anxiety and Depression Scale, and Resilience Scale-14 questionnaires before surgery and at 28 days and 52 weeks post surgery. The primary outcomes were life satisfaction and pain interference at 12 months after spine surgery and their associations with preoperative anxiety, depression, and resilience. : Data from 113 patients (94% response rate) were collected at 52 weeks postoperatively. The number of patients reporting satisfaction with their life increased from three (5%) and two (3%) before surgery to 23 (41%) and 19 (34%), while pain interference decreased from a median of 4.1 to 1.2 and from 4.4 to 1.9 on a scale of 0-10 at 12 months in the placebo and tramadol-paracetamol groups, respectively. The linear regression analysis revealed no statistically significant predictive value for preoperative anxiety, depression, or resilience score for life satisfaction and pain interference at 12 months after spine surgery. : These results highlight that psychological factors, anxiety, depression, and resilience did not have an impact on postoperative pain outcomes and life satisfaction in patients undergoing spine surgery.
心理因素会影响患者报告的结局指标（PROMs）。本研究评估了术前焦虑、抑郁和心理韧性对脊柱手术后一年的术后疼痛干扰和生活满意度的影响。本研究是对一项涉及120例行择期脊柱手术患者的研究的二次分析，这些患者被随机分配，在术后的前五天每天两次接受曲马多-对乙酰氨基酚（37.5毫克/325毫克；两片；n = 61）或安慰剂（n = 59）用于疼痛管理。患者在手术前、术后28天和52周完成了生活满意度量表-4、简明疼痛问卷、医院焦虑抑郁量表和心理韧性量表-14问卷。主要结局是脊柱手术后12个月时的生活满意度和疼痛干扰，以及它们与术前焦虑、抑郁和心理韧性的关联。术后52周收集了113例患者（应答率94%）的数据。报告对生活满意的患者数量从手术前的3例（5%）和2例（3%）增加到术后12个月时安慰剂组和曲马多-对乙酰氨基酚组分别为23例（41%）和19例（34%），而疼痛干扰在0至10分的量表上分别从安慰剂组的中位数4.1降至1.2和曲马多-对乙酰氨基酚组的4.4降至1.9。线性回归分析显示，术前焦虑、抑郁或心理韧性评分对脊柱手术后12个月时的生活满意度和疼痛干扰没有统计学上的显著预测价值。这些结果表明，心理因素、焦虑、抑郁和心理韧性对接受脊柱手术的患者的术后疼痛结局和生活满意度没有影响。
