Impact of depression on functional status in elderly patients undergoing total knee arthroplasty
Bibliographic record
Abstract
BACKGROUND The prevalence of depressive symptoms in patients undergoing total knee arthroplasty (TKA) ranges from 22% to 26%. The impact of depression on functional status post-TKA remains controversial. AIM To be the first study in Latin American population to evaluate the association between depression and functional status one year after TKA, hypothesizing that elderly patients with depression will demonstrate lower rates of functional improvement. METHODS We conducted an observational, descriptive and analytic, retrospective cohort study involving patients over 65 years old who were indicated for TKA. Assessments were made via the Program for Determination and Management of Risks for Practices and Procedures of the Division of Geriatric Medicine at the Italian Hospital of Buenos Aires, between June 2015 and July 2019. Depression screening was conducted using Yesavage’s abbreviated score and Patient Health Questionnaire-9, while functional ability was evaluated using the Knee Society Score (KSS). RESULTS Of the 100 patients analyzed, 22 (22%) screened positive for depression. The mean age was 80 years ± 6.3 years, with an average of 77.6 years ± 6 years in the depressed group and 80.6 years ± 6.3 years in the non-depressed group (P = 0.05). Depressed patients showed significantly greater cognitive impairment [clock-face drawing test median: 5 (3-6) vs 6 (5-7), P = 0.06] and more risk factors for confusional syndrome (mean: 8 ± 2 vs 6.5 ± 2.2, P = 0.006). Frailty was also more prevalent in depressed patients [Edmonton: 15 (68%) vs 33 (42%), P = 0.05; Fried: 17 (77%) vs 42 (54%), P = 0.05]. Postoperative Functional KSS were similar between groups (depressed: 65 ± 22.1 vs non-depressed: 66.3 ± 20.3, P = 0.8). Linear regression analysis revealed no association between depression and changes in KSS. Spearman’s rank correlation coefficients were -0.0304 (P = 0.8) for Functional KSS variation and -0.1 (P = 0.3) for KSS variation. CONCLUSION Depression in patients with osteoarthritis should not hinder surgical planning. Identifying and treating depression preoperatively may enhance outcomes such as pain relief and reduce risks of acute confusional syndrome, cognitive impairment, and frailty.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".