Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Jun 19, 2024; 14(6): 838-847
Published online Jun 19, 2024. doi: 10.5498/wjp.v14.i6.838
Relationship between preoperative psychological stress and short-term prognosis in elderly patients with femoral neck fracture
Wen-Hui Fu, Zhi-Long Hu, Yuan-Jun Liao, Ri-Jiang Chen, Jian-Bin Qiu, Wu-Tang Que, Wan-Tao Wang, Wei-Hua Li, Wei-Bin Lan
Wen-Hui Fu, Zhi-Long Hu, Yuan-Jun Liao, Ri-Jiang Chen, Jian-Bin Qiu, Wu-Tang Que, Wan-Tao Wang, Wei-Hua Li, Wei-Bin Lan, Department of Orthopedics, Longyan First Affiliated Hospital of Fujian Medical University, Longyan 361000, Fujian Province, China
Co-first authors: Wen-Hui Fu and Zhi-Long Hu.
Author contributions: Fu WH and Hu ZL designed the research, they contributed equally to this manuscript; Liao YJ, Chen RJ, and Qiu JB collected information and data; Que WT, Wang WT, and Li WH performed statistical analysis; Lan WB supervised the study and revised the manuscript for important intellectual content; and all authors read and approved the final version of the manuscript.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of the Longyan First Affiliated Hospital of Fujian Medical University, Approval No. 2020(90).
Informed consent statement: All study participants or their legal guardians provided written informed consent for personal and medical data collection before enrolling in the study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The data used in this study can be obtained from the corresponding author upon request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wei-Bin Lan, MM, Associate Professor, Department of Orthopedics, Longyan First Affiliated Hospital of Fujian Medical University, No. 105 Jiuyi North Road, Xinluo District, Longyan 361000, Fujian Province, China. lanweibin2004@163.com
Received: February 28, 2024
Revised: April 23, 2024
Accepted: May 6, 2024
Published online: June 19, 2024
Processing time: 112 Days and 9.9 Hours
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.

Keywords: Psychological stress; Old age; Femoral neck fracture; Hip replacement; Short-term prognosis; Correlation

Core Tip: Femoral neck fractures (FNF) are primarily caused by the loss of osteoporotic bone mass, and they tend to affect elderly adults. Some elderly patients with FNF have poor post-surgical outcomes due to unknown causes. We retrospectively analyzed the clinical data of 120 elderly patients with FNF and found that preoperative psychological stress was associated with a poor short-term prognosis in these patients, which is a breakthrough discovery in the understanding of the cause of poor prognosis among elderly patients with FNF.