Observational Study
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World J Clin Cases. Jan 21, 2022; 10(3): 919-928
Published online Jan 21, 2022. doi: 10.12998/wjcc.v10.i3.919
Prevalence of depression and anxiety and associated factors among geriatric orthopedic trauma inpatients: A cross-sectional study
Jia-Lei Chen, Rong Luo, Ming Liu
Jia-Lei Chen, Rong Luo, Ming Liu, Department of Orthopedics, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Chen JL performed study design, data collection and manuscript drafting and revision; Luo R performed data analysis and interpretation; Liu M performed language editing and data collection; all authors have read and approved the manuscript.
Institutional review board statement: This study was reviewed and approved by the Biomedical Research Ethical Committee of West China Hospital of Sichuan University (Approval No. 2020-29).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
Data sharing statement: The data used and/or analyzed during the current study are available from the corresponding author on reasonable request.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
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: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jia-Lei Chen, MD, PhD, Attending Doctor, Department of Orthopedics, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Wuhou District, Chengdu 610041, Sichuan Province, China. chenjialei2016@wchscu.cn
Received: July 18, 2021
Peer-review started: July 18, 2021
First decision: October 16, 2021
Revised: October 22, 2021
Accepted: December 22, 2021
Article in press: December 22, 2021
Published online: January 21, 2022
Processing time: 181 Days and 1.4 Hours
Abstract
BACKGROUND

Common mental disorders such as anxiety and depression in geriatric orthopedic trauma patients have received little attention in research.

AIM

To investigate the prevalence of emotional disorders among geriatric orthopedic trauma patients and identify demographic, social and clinical risk factors.

METHODS

This cross-sectional study was performed in geriatric patients (aged ≥ 60 years, both sexes) with orthopedic trauma admitted to a level I trauma center between May 2015 and December 2017. Demographic, social, and clinical characteristics were described. Huaxi Emotional-Distress Index (HEI) was used to evaluate the severity of anxiety and depression status. Differences in continuous variables were tested using the t-test, and differences in categorical variables were assessed using the Pearson χ2 test. Binary logistic regression analyses were used to identify the factors associated with a HEI score > 8.

RESULTS

Among the 966 patients, 487 were male and 479 were female, with a mean age of 70.2 ± 7.1 years. The age ranged from 60 to 90 years. Seventy-five patients had an HEI score > 8, accounting for about 7.8% of all patients. A higher Injury Severity Score (4.17 ± 3.10 vs 7.96 ± 6.68, P < 0.001), higher Visual Analog Score (5.05 ± 1.09 vs 6.89 ±1.23, P < 0.001), number of chronic diseases (P < 0.001), injury type (P = 0.038), and education level (P = 0.001) were significantly associated with HEI score > 8. On logistic regression, a higher education level was a protective factor for emotional disorders (P = 0.047), whereas Injury Severity Score (P = 0.024), Visual Analog Score (P < 0.001), two or more chronic diseases (P < 0.001) were the related independent risk factors.

CONCLUSION

Emotional disorders are common in geriatric patients with orthopedic trauma. Clinicians should remain vigilant of emotional disorders in geriatric patients and screen for anxiety and depression in higher risk groups.

Keywords: Anxiety; Depression; Geriatric; Trauma; Orthopedic

Core Tip: Anxiety and depression in geriatric orthopedic trauma patients have received little attention in research. Therefore, in present study, we use Huaxi Emotional-Distress Index as a psycho-metrically screening tool for anxiety and depression in geriatric orthopedic trauma inpatients at a single center. The main finding is that emotional disorders are prevalent in geriatric orthopedic trauma inpatients. In addition, Injury Severity Score, Visual Analog Score, and two or more coexist chronic diseases are independent risk factors, whereas a higher education level is a protective factor. Clinicians should remain vigilant of emotional disorders in geriatric patients and screen for anxiety and depression in higher risk groups.