Walter Nike, Loew Thomas, Hinterberger Thilo, Mohokum Melvin, Alt Volker, Rupp Markus
Department for Psychosomatic Medicine, University Hospital Regensburg, Regensburg, Germany.
Faculty of Health, Safety, Society, Furtwangen University, Freiburg, Germany.
Bone Joint Res. 2025 Feb 20;14(2):136-142. doi: 10.1302/2046-3758.142.BJR-2024-0086.R2.
Fracture-related infections (FRIs) are a major concern for patients and healthcare systems, yet their impact on mental health has been largely overlooked. This study aimed to assess the longitudinal impact of FRI on patients' quality of life.
A prospective study was conducted at a level 1 trauma centre between January 2020 and December 2022. In total, 56 patients participated, with quality of life assessed at five timepoints: one week preoperatively, and one, three, six, and 12 months postoperatively. Statistical analysis was performed using repeated measures analysis of variance (ANOVA) with adjusted post-hoc analysis.
The preoperative Physical Component Summary score on the 36-Item Short-Form Health Survey questionnaire (SF-36) was 26.71, increasing to 30.40 at one month, remaining stable at three months. A modest increase was observed at six months (32.45, p = 0.003), but it decreased to 29.72 at 12 months. The preoperative Mental Component Summary score (SF-36) was 46.48, decreasing to 39.89 at one month (p = 0.027) and to 36.03 at three months (p ≤ 0.001). However, it improved at six (42.74) and 12 months (44.05). Positive changes were seen in EuroQol five-dimension questionnaire (EQ-5D) subdimensions, such as mobility, self-care, usual activities, and pain/discomfort, while anxiety/depression scores decreased over time. The EQ-5D visual analogue scale (VAS) score increased to 62.79 at six months (p ≤ 0.001) and decreased to 58.2 at 12 months (p = 0.011).
FRIs substantially affect mental health and quality of life, particularly during the initial three months of treatment. This study emphasizes the importance of addressing psychological aspects early in FRI management, advocating for holistic care encompassing both physical and psychological aspects of treatment.
骨折相关感染（FRI）是患者和医疗系统主要关注的问题，但其对心理健康的影响在很大程度上被忽视了。本研究旨在评估FRI对患者生活质量的长期影响。
于2020年1月至2022年12月在一家一级创伤中心进行了一项前瞻性研究。共有56名患者参与，在五个时间点评估生活质量：术前一周，术后1个月、3个月、6个月和12个月。采用重复测量方差分析（ANOVA）及校正后的事后分析进行统计分析。
36项简短健康调查问卷（SF-36）的术前身体成分总结得分是26.71，1个月时增至30.40，3个月时保持稳定。6个月时观察到适度增加（32.45，p = 0.003），但12个月时降至29.72。术前心理成分总结得分（SF-36）为46.48，1个月时降至39.89（p = 0.027），3个月时降至36.03（p≤0.001）。然而，6个月（42.74）和12个月（44.05）时有所改善。欧洲五维健康量表（EQ-5D）子维度出现了积极变化，如活动能力、自我护理、日常活动和疼痛/不适，而焦虑/抑郁得分随时间下降。EQ-5D视觉模拟量表（VAS）得分在6个月时增至62.79（p≤0.001），12个月时降至58.2（p = 0.011）。
FRI对心理健康和生活质量有重大影响，尤其是在治疗的最初三个月。本研究强调了在FRI管理中尽早关注心理方面的重要性，提倡对治疗的身体和心理方面进行全面护理。
