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Fu WH, Hu ZL, Liao YJ, Chen RJ, Qiu JB, Que WT, Wang WT, Li WH, Lan WB. Relationship between preoperative psychological stress and short-term prognosis in elderly patients with femoral neck fracture. World J Psychiatry 2024; 14:838-847. [DOI: 10.5498/wjp.v14.i6.838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 04/23/2024] [Accepted: 05/06/2024] [Indexed: 06/19/2024] Open
Abstract
BACKGROUND Older adults are at high risk of femoral neck fractures (FNFs). Elderly patients face and adapt to significant psychological burdens, resulting in different degrees of psychological stress response. Total hip replacement is the preferred treatment for FNF in elderly patients; however, some patients have poor postoperative prognoses, and the underlying mechanism is unknown. We speculated that the postoperative prognosis of elderly patients with FNF may be related to preoperative psychological stress.
AIM To explore the relationship between preoperative psychological stress and the short-term prognosis of elderly patients with FNF.
METHODS In this retrospective analysis, the baseline data, preoperative 90-item Symptom Checklist score, and Harris score within 6 months of surgery of 120 elderly patients with FNF who underwent total hip arthroplasty were collected. We analyzed the indicators of poor short-term postoperative prognosis and the ability of the indicators to predict poor prognosis and compared the correlation between the indicators and the Harris score.
RESULTS Anxiety, depression, garden classification of FNF, cause of fracture, FNF reduction quality, and length of hospital stay were independent influencing factors for poor short-term postoperative prognoses in elderly patients with FNF (P < 0.05). The areas under the curve for anxiety, depression, and length of hospital stay were 0.742, 0.854, and 0.749, respectively. The sensitivities of anxiety, depression, garden classification of FNF, and prediction of the cause of fracture were 0.857, 0.786, 0.821, and 0.821, respectively. The specificities of depression, FNF quality reduction, and length of hospital stay were the highest at 0.880, 0.783, and 0.761, respectively. Anxiety, depression, and somatization scores correlated moderately with Harris scores (r = -0.523, -0.625, and -0.554; all P < 0.001).
CONCLUSION Preoperative anxiety, depression, and somatization are correlated with poor short-term prognosis in elderly patients with FNF and warrant consideration.
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Affiliation(s)
- Wen-Hui Fu
- Department of Orthopedics, Longyan First Affiliated Hospital of Fujian Medical University, Longyan 361000, Fujian Province, China
| | - Zhi-Long Hu
- Department of Orthopedics, Longyan First Affiliated Hospital of Fujian Medical University, Longyan 361000, Fujian Province, China
| | - Yuan-Jun Liao
- Department of Orthopedics, Longyan First Affiliated Hospital of Fujian Medical University, Longyan 361000, Fujian Province, China
| | - Ri-Jiang Chen
- Department of Orthopedics, Longyan First Affiliated Hospital of Fujian Medical University, Longyan 361000, Fujian Province, China
| | - Jian-Bin Qiu
- Department of Orthopedics, Longyan First Affiliated Hospital of Fujian Medical University, Longyan 361000, Fujian Province, China
| | - Wu-Tang Que
- Department of Orthopedics, Longyan First Affiliated Hospital of Fujian Medical University, Longyan 361000, Fujian Province, China
| | - Wan-Tao Wang
- Department of Orthopedics, Longyan First Affiliated Hospital of Fujian Medical University, Longyan 361000, Fujian Province, China
| | - Wei-Hua Li
- Department of Orthopedics, Longyan First Affiliated Hospital of Fujian Medical University, Longyan 361000, Fujian Province, China
| | - Wei-Bin Lan
- Department of Orthopedics, Longyan First Affiliated Hospital of Fujian Medical University, Longyan 361000, Fujian Province, China
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Jin Z, Chen L, Wang D, Ye Y, Fu J, Yang Z, He B. A prediction model for osteonecrosis of femoral head after internal fixation with multiple cannulated compression screws for adult femoral neck fractures. Jt Dis Relat Surg 2024; 35:20-26. [PMID: 38108162 PMCID: PMC10746905 DOI: 10.52312/jdrs.2024.975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 08/10/2023] [Indexed: 12/19/2023] Open
Abstract
OBJECTIVES This study aims to investigate the high-risk factors for osteonecrosis of the femoral head (ONFH) after internal fixation with multiple cannulated compression screws for adult femoral neck fractures and to construct a prediction model. PATIENTS AND METHODS Between from January 2012 and December 2020, a total of 268 patients (138 males, 130 females; mean age: 53±10 years; range, 23 to 70 years) with ONFH who had complete follow-up data were included. Closed reduction in combination with open reduction were performed. All patients received internal fixation with multiple cannulated compression screws and were assigned to ONFH and non-ONFH groups. Logistic regression model was utilized to identify independent risk factors for postoperative ONFH, followed by constructing a nomogram prediction model. The predictive ability of the model was evaluated by receiver operating characteristic curve, Hosmer-Lemeshow test, and calibration curve. RESULTS Multivariate analysis revealed that older age (odds ratio [OR]: 2.307, 95% confidence interval [CI]: 1.295-4.108], Charlson Comorbidity Index (CCI) ≥2 (OR: 2.214, 95% CI: 1.035-4.739), fracture displacement (OR: 2.426, 95% CI: 1.122-5.247), unsatisfactory reduction (OR: 2.629, 95% CI: 1.275-5.423), postoperative removal of internal fixation implant (OR: 2.200, 95% CI: 1.051-4.604) were independent risk factors for postoperative ONFH (p<0.05). The nomogram prediction model constructed based on these clinical characteristics showed high predictive value (AUC=0.807) and consistency (p>0.05). CONCLUSION Age, comorbidity index, fracture type, reduction quality and postoperative removal of internal fixation implant are of utmost importance for postoperative ONFH in patients with femoral neck fractures. The established nomogram prediction model can accurately predict the occurrence of postoperative ONFH.
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Affiliation(s)
| | | | | | | | | | | | - Baoqiang He
- Department of Acupuncture, Yangxian People's Hospital, Hanzhong 723300, Shaanxi Province, China.
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Van Vehmendahl R, Nelen SD, El Hankouri M, Edwards MJR, Pull ter Gunne AF, Smeeing DPJ. Effectiveness of Postoperative Physiotherapy Compared to Postoperative Instructions by Treating Specialist Only in Patients With an Ankle Fracture: A Systematic Review. FOOT & ANKLE ORTHOPAEDICS 2023; 8:24730114231173680. [PMID: 37197389 PMCID: PMC10184230 DOI: 10.1177/24730114231173680] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2023] Open
Abstract
Background In current literature, the benefit of postoperative physiotherapy versus postoperative instructions by treating specialist only remains unclear. The aim of this review is to systematically assess existing literature regarding the functional outcome of postoperative physiotherapy compared to postoperative instructions by treating specialist only in the rehabilitation of patients with an ankle fracture. The secondary aim is to determine if there is a difference in ankle range of motion, strength, pain, complications, quality of life, and patient's satisfaction between these 2 rehabilitation methods. Methods For this review, the PubMed/MEDLINE, PEDro, Embase, Cochrane, and CINAHL databases were searched for studies that compared postoperative rehabilitation groups. Results The electronic data search detected 20 579 articles. After exclusion, 5 studies with a total of 552 patients were included. Overall, no significant benefit in functional outcome of postoperative physiotherapy was seen compared to the instructions-only group. One study even found a significant benefit in favor of the instructions-only group. An exemption for beneficial effect of the use of physiotherapy could be made for younger patients, as 2 studies described younger age as a factor for better outcomes (functional outcome and ankle range of motion) in the postoperative physiotherapy group. Patients' satisfaction, described by one study, was found to be significantly higher in the physiotherapy group (P = .047). All other secondary aims showed no significant difference. Conclusion Because of the limited number of studies and the heterogeneity among studies, a valid conclusion about the general effect of physiotherapy cannot be formed. However, we identified limited evidence suggesting a possible benefit of physiotherapy in younger patients with an ankle fracture in functional outcome and ankle range of motion.
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Affiliation(s)
- Robyn Van Vehmendahl
- Department of Trauma Surgery, Radboud University Medical Centre, Nijmegen, the Netherlands
- Robyn Van Vehmendahl, MD, Department of Trauma Surgery, Radboud University Medical Centre, Geert Grooteplein Zuid 10, Nijmegen, 6525GA, the Netherlands.
| | - Stijn D. Nelen
- Department of Trauma Surgery, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Mouhcine El Hankouri
- Department of Trauma Surgery, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Michael J. R. Edwards
- Department of Trauma Surgery, Radboud University Medical Centre, Nijmegen, the Netherlands
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Milton-Cole R, Ayis S, O'Connell MDL, Smith T, Sheehan KJ. Trajectories of Depressive Symptoms Among Older Adults and in Adults With Hip Fracture: Analysis From the English Longitudinal Study of Ageing. J Gerontol A Biol Sci Med Sci 2022; 77:2453-2458. [PMID: 36073633 PMCID: PMC9799186 DOI: 10.1093/gerona/glac182] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND This study aimed to determine trajectories of depressive symptoms among older adults in England, overall and for those with hip fracture. The study aimed to explore the differential characteristics of each trajectory identified. METHODS Analysis of adults aged 60 years or more (n = 7 050), including a hip fracture subgroup (n = 384), from the English Longitudinal Study of Ageing. Latent class growth mixture modeling was completed. Depressive symptom prevalence was estimated at baseline. Chi-square tests were completed to compare baseline characteristics across trajectories. RESULTS Three trajectories of depressive symptoms (no, mild, and moderate-severe) were identified overall and for those with hip fracture. The moderate-severe trajectory comprised 13.7% and 7% of participants for overall and hip fracture populations, respectively. The proportion of participants with depressive symptoms in the moderate-severe trajectory was 65.4% and 85.2% for overall and hip fracture populations, respectively. Depressive symptoms were stable over time, with a weak trend toward increasing severity for the moderate-severe symptom trajectory. Participants in the moderate-severe symptom trajectory were older, more likely to be female, live alone, and had worse health measures than other trajectories (p < .001). CONCLUSIONS Older adults, and those with hip fracture, follow one of the 3 trajectories of depressive symptoms that are broadly stable over time. Depressive symptoms' prevalence was higher for those with hip fracture and, when present, the symptoms were more severe than the overall population. Results suggest a role of factors including age, gender, and marital status in depressive symptom trajectories.
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Affiliation(s)
- Rhian Milton-Cole
- Department of Population Health Sciences, School of Life Course and Population Sciences, King's College London, London, UK
| | - Salma Ayis
- Department of Population Health Sciences, School of Life Course and Population Sciences, King's College London, London, UK
| | - Matthew D L O'Connell
- Department of Population Health Sciences, School of Life Course and Population Sciences, King's College London, London, UK
| | - Toby Smith
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
| | - Katie Jane Sheehan
- Department of Population Health Sciences, School of Life Course and Population Sciences, King's College London, London, UK
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Li H, Hu Y, Gan L, Wang Y. Observation of the clinical effectiveness of evidence-based nursing for patients with a vertebral osteoporotic fracture. J Back Musculoskelet Rehabil 2022; 36:517-523. [PMID: 36404532 DOI: 10.3233/bmr-220161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND An osteoporotic fracture (OPF) can significantly affect patients' activities of daily living (ADLs). OBJECTIVE This study observed the effects of evidence-based nursing (EBN) on the occurrence of postoperative complications and ADLs in patients with a vertebral OPF. METHODS A total of 90 patients with vertebral OPF were divided into two groups. The conventional orthopedic nursing method was conducted for the control group, and the EBN model was delivered for the observation group. RESULTS Differences in the Barthel index (BI) score on the first day of admission were not statistically significant between the two groups. The BI scores on the day before discharge, compared with the day of admission, had improved in both groups. The BI score on the day before discharge was 83.67 ± 6.94 in the observation group, and the difference was statistically significant (P< 0.05) compared with the control group (76.56 ± 6.89). The rate of satisfaction with nursing in the observation group (100.0%) was significantly higher than in the control group (82.2%) (P< 0.05). The incidence of postoperative complications in the observation group (2.2%) was significantly lower than in the control group (24.4%) (P< 0.05). CONCLUSIONS The implementation of EBN in patients with vertebral OPF improved the postoperative ADLs, reduced the incidence of postoperative complications, and improved the patients' satisfaction with nursing.
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Affiliation(s)
- Hui Li
- Department of Orthopedics, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.,Department of Orthopedics, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Ying Hu
- Department of Nephrology, The First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China.,Department of Orthopedics, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Lin Gan
- Department of Orthopedics, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - YiXuan Wang
- Department of Orthopedics, The Second Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China
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