Xu Lining, Xu Yingying, Li Guiping, Yang Bo
Department of General Surgery, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, 100853, China.
Department of Internal Medicine, Henan Cancer Hospital, Zhengzhou, 450003, China.
ILIVER. 2022 Jun 15;1(2):111-116. doi: 10.1016/j.iliver.2022.05.002. eCollection 2022 Jun.
Allopatry medical treatment is common in China. However, allopatry medical therapy can result in many problems, including a negative psychological impact on patients. Patients undergoing liver surgery often experience anxiety and depression. To understand the psychological status of older adult patients undergoing surgery better, this study was designed to investigate the incidence of anxiety and depression in older adult patients undergoing elective liver surgery and to analyze factors associated with it in allopatry medical therapy.
A total of 173 older adult patients undergoing elective liver surgery were included in the study. Patients were evaluated using the hospital anxiety and depression scale (HADS). The contributing factors affecting the psychological state of older adult patients undergoing elective surgery were analyzed using a linear regression method.
The HADS-A (hospital anxiety and depression scale-anxiety). The correlation (scale) score of the older adult patients undergoing elective liver surgery was (8.69 ± 2.38), including 53 asymptomatic patients, 86 suspicious patients, and 34 symptomatic patients. The HADS-D (hospital anxiety and depression scale-depression) score was (8.31 ± 2.90), including 83 asymptomatic patients, 56 suspicious patients, and 34 symptomatic patients. Multivariate analysis showed that residence and complication grade (Clavien-Dindo Classification of Surgical Complications or Accordion Severity Grading System) significantly correlated with the anxiety level of patients undergoing elective surgery. Residence, a requirement of blood transfusion, total transfusion volume, and Accordion complication grade showed a significant correlation with depression in patients undergoing elective surgery.
Anxiety and depression in older adult patients undergoing elective liver surgery were common. Regional differences (local patients non local patients) and the severity of complications were the risk factors for anxiety and depression in older adult patients undergoing elective liver surgery. Reducing both regional differences and the severity of complications would be beneficial to alleviate the risk of anxiety and depression in older adult patients undergoing elective liver surgery and thus promote their physical and mental health.
异地就医在中国很常见。然而，异地医疗可能会导致许多问题，包括对患者产生负面心理影响。接受肝脏手术的患者经常会出现焦虑和抑郁情绪。为了更好地了解老年手术患者的心理状况，本研究旨在调查择期肝脏手术老年患者焦虑和抑郁的发生率，并分析异地就医中与之相关的因素。
本研究共纳入173例接受择期肝脏手术的老年患者。采用医院焦虑抑郁量表（HADS）对患者进行评估。采用线性回归方法分析影响择期手术老年患者心理状态的相关因素。
择期肝脏手术老年患者的医院焦虑抑郁量表焦虑分量表（HADS-A）相关（量表）评分为（8.69±2.38），其中无症状患者53例，可疑患者86例，有症状患者34例。医院焦虑抑郁量表抑郁分量表（HADS-D）评分为（8.31±2.90），其中无症状患者83例，可疑患者56例，有症状患者34例。多因素分析显示，居住地和并发症分级（Clavien-Dindo手术并发症分类或手风琴严重程度分级系统）与择期手术患者的焦虑水平显著相关。居住地、输血需求、总输血量和手风琴并发症分级与择期手术患者的抑郁显著相关。
择期肝脏手术老年患者焦虑和抑郁情况较为常见。地区差异（本地患者与非本地患者）和并发症严重程度是择期肝脏手术老年患者焦虑和抑郁的危险因素。减少地区差异和并发症严重程度将有助于降低择期肝脏手术老年患者焦虑和抑郁的风险，从而促进其身心健康。
