Li Bo, Li Cha, Zhong Xian-Jiang, Xu Xiang-Rong
Department of Burns and Plastic Surgery, Changde Hospital, Xiangya School of Medicine, Central South University (The First People's Hospital of Changde City), Changde 415000, Hunan Province, China.
Department of Pediatric Intensive Care Unit, Changde Hospital, Xiangya School of Medicine, Central South University (The First People's Hospital of Changde City), Changde 415000, Hunan Province, China.
World J Psychiatry. 2024 Dec 19;14(12):1836-1844. doi: 10.5498/wjp.v14.i12.1836.
The incidence of chronic wounds is rising due to an aging population and lifestyle changes in our country. In addition, as the disease spectrum evolves, chronic wounds have become common clinical issues that seriously threaten health and impose significant social and economic burdens.
To investigate how depression, anxiety, peripheral blood inflammatory factors, and stress levels affect therapeutic outcomes in patients with chronic wounds.
Retrospectively collected clinical data from 110 patients with chronic wounds treated at Changde Hospital, Xiangya School of Medicine, Central South University (The First People's Hospital of Changde City) between January 2021 and December 2023, categorizing them into effective and ineffective groups based on treatment effects. Differences between both groups were analyzed using univariate analysis, independent risk factors identified logistic regression, and their predictive value assessed through receiver operating characteristic analysis.
Following treatment, 95 cases were classified as the effective group (cured or improved), while 15 cases with improvement formed the ineffective group. Significant differences between both groups were noted in wound area, infection status, daily bed time, Hamilton Anxiety Rating Scale (HAMA) scores, Hamilton Depression Rating Scale (HAMD) scores, and levels of interleukin-6, tumor necrosis factor-alpha, and superoxide dismutase ( < 0.05). Logistic regression analysis identified a wound area ≥ 7 cm, HAMA ≥ 9 scores, and HAMD ≥ 8 scores were independent risk factors for ineffective treatment in patients with chronic wounds ( < 0.05). The receiver operating characteristic curve analysis revealed that the area under the curve for ineffective treatment based on wound area, HAMA, and HAMD was 0.767, 0.805, and 0.768 respectively.
Wound size, anxiety, and depression are significant factors influencing the therapeutic outcomes in patients with chronic wounds that require careful attention, alongside the development of appropriate strategies.
由于我国人口老龄化和生活方式的改变,慢性伤口的发病率正在上升。此外,随着疾病谱的演变,慢性伤口已成为严重威胁健康并带来重大社会和经济负担的常见临床问题。
探讨抑郁、焦虑、外周血炎症因子和应激水平如何影响慢性伤口患者的治疗效果。
回顾性收集2021年1月至2023年12月在中南大学湘雅医学院常德医院(常德市第一人民医院)接受治疗的110例慢性伤口患者的临床资料,根据治疗效果将其分为有效组和无效组。采用单因素分析两组间的差异,通过逻辑回归确定独立危险因素,并通过受试者工作特征分析评估其预测价值。
治疗后,95例被分类为有效组(治愈或改善),而15例改善不明显的患者组成无效组。两组在伤口面积、感染状况、每日卧床时间、汉密尔顿焦虑量表(HAMA)评分、汉密尔顿抑郁量表(HAMD)评分以及白细胞介素-6、肿瘤坏死因子-α和超氧化物歧化酶水平方面存在显著差异(<0.05)。逻辑回归分析确定伤口面积≥7 cm、HAMA≥9分和HAMD≥8分为慢性伤口患者治疗无效的独立危险因素(<0.05)。受试者工作特征曲线分析显示,基于伤口面积、HAMA和HAMD的治疗无效曲线下面积分别为0.767、0.805和0.768。
伤口大小、焦虑和抑郁是影响慢性伤口患者治疗效果的重要因素,需要密切关注,并制定相应的策略。