Depression and Anxiety Are Risk Factors for Postoperative Pain-Related Symptoms and Complications in Patients Undergoing Primary Total Knee Arthroplasty in the United States

Pan, Xin; Wang, Jian; Lin, Zhaowei; Dai, Wenli; Shi, Zhanjun

doi:10.1016/j.arth.2019.05.035

Cited by 102 publications

(101 citation statements)

References 33 publications

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“…6 Klement 18 A similar study evaluating the NIS of 7,153,750 pTKA patients from 2002 to 2014 found a prevalence of depression in 10.98%, with this prevalence trending upward as well. 17 A retrospective review of a single institution in 2009 found similar rates of depression (12.7%) in pTKA populations. 29 Wieser et al 36 reported on a prospectively collected database seeking to identify the effects of illicit IV drug abuse in THAs and reported a prevalence of 0.9% in 2,625 pTHAs.…”

Section: Discussionmentioning

confidence: 95%

“…16 Patients with mental health disorders, including depression, schizophrenia, and fibromyalgia appear to be at an increased risk for medical complications and readmission following pTKA. [17][18][19][20][21][22] Similarly, the risk of surgical complications such as periprosthetic joint infection (PJI), fracture, revision, and extensor mechanism rupture increases as well. 12,23,24 Specifically, the risk of PJI increases 217% at the 90 day postoperative mark when a mental health International Classification of Disease 9th edition (ICD-9) diagnosis code was found in the patients chart.…”

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confidence: 99%

“…29 This is further supported by a retrospective database study that found that those patients with depression had a 8.3% increase in total charges, compared with patients without a mental health conditions. 17 PJI is a devastating diagnosis with up to 70% 5-year survival rate, worse than many types of cancer including testicular, breast, and melanoma. 30,31 With similar survival rates to PJI, cancer diagnoses has been shown to dramatically increase mental health conditions.…”

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confidence: 99%

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Greater Prevalence of Mental Health Conditions in Septic Revision Total Knee Arthroplasty: A Call to Action

et al. 2020

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The purpose of this study was to compare the prevalence of mental health conditions among patients undergoing (1) primary total knee arthroplasty (pTKA), (2) septic revision total knee arthroplasty (rTKA), and (3) aseptic revision total knee arthroplasty (TKA). The State Inpatient Databases were queried for all TKAs from 2005 to 2014 yielding 563,144 patients. Patients were separated into the following cohorts: primary, septic revision, and aseptic revision. Diagnoses of any mental health condition and the following specific conditions were compared between the three cohorts: schizophrenia/delusion, bipolar disorder, depression/mood disorder, personality disorder, anxiety/somatic/dissociative disorder, eating disorders, attention deficit hyperactivity disorder /conduct/impulse control, alcohol abuse, and drug abuse. Throughout the study period, an increase in the prevalence of mental health conditions was observed in septic and aseptic revision patients. Overall, there was a significantly higher prevalence of mental health conditions in the septic revision cohort (22.7%) compared with the primary (17.8%, p < 0.001) and aseptic revision (20.0%, p < 0.001) cohorts. Specifically, septic revision TKA patients had a higher prevalence of depression (p < 0.001), alcohol abuse (p < 0.001), drug abuse (p < 0.001), schizophrenia (p = 0.0007), and bipolar disorder (p < 0.001), compared with primary TKA patients. Additionally, there was a significantly higher prevalence of depression (p < 0.001), alcohol abuse (p < 0.001), and drug abuse (p < 0.001) among septic revision patients compared with aseptic revision patients. Mental health conditions were significantly higher among septic revision patients. Alcohol and drug abuse were approximately twice as prevalent in septic revision patients compared with primary and aseptic revision patients. These findings should serve as a call to action for mental health support for patients suffering from PJI.

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Section: Discussionmentioning

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Greater Prevalence of Mental Health Conditions in Septic Revision Total Knee Arthroplasty: A Call to Action

et al. 2020

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“…About 30% of TKA patients have psychological distress before surgery. [ 8 ] Anxiety disorders are considered common mental illnesses, with high worldwide prevalence. [ 9 ] It has been reported that the patients who are considered anxious have worse outcome score than the patients with higher scores of psychosocial component.…”

Section: Introductionmentioning

confidence: 99%

“…Even if we consider their importance, only a few researches have tried to determine the existence of psychological disorders such as anxiety. Pan et al [ 8 ] have reported a steady increase in the prevalence of anxiety in patients with TKA each year. The anxiety was closely related to the efficacy of TKA.…”

Section: Introductionmentioning

confidence: 99%

The efficacy of nursing intervention to reduce preoperative anxiety in patients with total knee arthroplasty

Fu¹,

Wang²,

Fan³

et al. 2020

Medicine

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Background: Some patients undergoing the total knee arthroplasty (TKA) have suboptimal postoperative results, and preoperative anxiety may be one of the reasons for these unsatisfactory results. We perform this randomized control study protocol to determine the effectiveness of nursing intervention, on the basis of motivational interview, to decrease the preoperative anxiety in patients receiving TKA. Methods: This is a double-blinded, single-center, placebo-controlled and randomized trial, which will be conducted from December 2020 to June 2021. The protocol of this study was approved by the West China Hospital of Sichuan University (W20200803-28). Sixty patients who will undergo TKA are included in our study. Patients are randomly divided into experiential group (with 30 patients) and the control group (with 30 patients). The control group and experimental group receive an informative and separate session via nursing about the operation preparation and operation process. Both the control group and the experimental group are given habitual treatment, but the experimental group need to receive additional motivational interviews. The primary outcomes are the Hospital Anxiety and Depression Scale and the Amsterdam Preoperative Anxiety and Information Scale. Secondary outcome is postoperative pain, which is assessed by visual analogue scale . Results: Figure 1 will display the comparison of preoperative and postoperative total average anxiety scores in control group and the experimental group. Conclusion: Preoperative psychological distress is familiar in our patients. We hypothesized that nursing intervention may be associated with reduced preoperative anxiety in the patients receiving TKA.

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Depression and anxiety symptoms are related to pain and frailty but not cognition or delirium in older surgical patients

et al. 2021

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Depression and Anxiety Are Risk Factors for Postoperative Pain-Related Symptoms and Complications in Patients Undergoing Primary Total Knee Arthroplasty in the United States

Cited by 102 publications

References 33 publications

Greater Prevalence of Mental Health Conditions in Septic Revision Total Knee Arthroplasty: A Call to Action

Greater Prevalence of Mental Health Conditions in Septic Revision Total Knee Arthroplasty: A Call to Action

The efficacy of nursing intervention to reduce preoperative anxiety in patients with total knee arthroplasty

Depression and anxiety symptoms are related to pain and frailty but not cognition or delirium in older surgical patients

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