Pre-operative Mental Health and Adverse Outcomes Following Total Knee Replacement: A Prospective Cohort Study
Notice bibliographique
Résumé
Aims Total knee replacements (TKRs) are effective procedures for severe osteoarthritis. Some studies suggest that people with common pre-operative mental health problems are more likely to experience complications following joint replacement. This study aimed to determine whether people who described pre-operative anxiety or depression were more likely to report an adverse event, or outcome, following a TKR. Methods A prospective cohort of people undergoing TKR at a surgical centre in England between 2012–2013 as part of service evaluation were studied. Following informed consent, participants completed pre-operative sociodemographic questionnaires alongside several patient-reported outcome measures (PROMs): the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), EuroQoL Five-dimensions Descriptive System (EQ-5D-3L), and the Self-Administered Patient Satisfaction Scale for Primary Knee Arthroplasty. Participants were classified as exposed if they described moderate or extreme problems with anxiety or depression in the mental health subset of the EQ-5D-3L. The primary outcome was the presence of a patient-reported adverse event (bleeding, infection or fracture) at 3 months post-surgery measured through a short postal questionnaire. Repeat PROMs were assessed at 3- and 12-months post-surgery. Logistic regression was used to model the association between pre-operative mental health status and probability of an adverse event, or outcome, occurring following adjustment for age, sex and body mass index. Results Of the 206 individuals studied, over a third (n 72/206, 35%) had reported problems with anxiety or depression before surgery. Among those returning completed follow-up questionnaires, 20% (n 34/168) described an adverse event at 3 months. Pre-operative anxiety or depression was not associated with an increased odds of reporting an adverse event (aOR 0.85, 95% CI 0.35–2.05) at 3 months post-surgery. People who described problems with anxiety or depression were more likely to have a greater degree of pre-operative functional impairment. Even after adjusting for a higher pre-operative symptom burden, exposed participants were more likely to report problems with activities of daily living (aOR 2.32, 95% CI 1.09–4.94) and pain or discomfort (aOR 5.58, 95% CI 1.77–17.60) at 3 months post-surgery. However, they did not have an increased odds of describing worse function, reduced health-related quality of life, or being dissatisfied with their TKR at 12 months post-surgery. Conclusion Despite having a higher burden of morbidity prior to undergoing surgery, pre-operatively anxious or depressed participants did not have an increased odds of reporting an adverse event at 3 months and went on to experience comparable improvements in PROMs at 12 months post-surgery.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».