Predictors of Incident Depression After Hip Fracture Surgery

Voshaar, Richard C. Oude; Banerjee, Sube; Horan, Mike; Baldwin, Robert C.; Pendleton, Neil; Proctor, Rebekah; Tarrier, Nick; Woodward, Yvonne; Burns, Alistair

doi:10.1097/jgp.0b013e318098610c

Cited by 40 publications

(45 citation statements)

References 26 publications

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“…To our knowledge, only two studies have reported exclusively on depressive symptoms developing post-fracture (Lenze et al . 2007; Oude Voshaar et al . 2007).…”

Section: Introductionmentioning

confidence: 99%

Trajectories of depressive symptoms after hip fracture

et al. 2016

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Background Hip fracture is often complicated by depressive symptoms in older adults. We sought to characterize trajectories of depressive symptoms arising after hip fracture and examine their relationship with functional outcomes and walking ability. We also investigated clinical and psychosocial predictors of these trajectories. Method We enrolled 482 inpatients, aged ≥60 years, who were admitted for hip fracture repair at eight St Louis, MO area hospitals between 2008 and 2012. Participants with current depression diagnosis and/or notable cognitive impairment were excluded. Depressive symptoms and functional recovery were assessed with the Montgomery–Asberg Depression Rating Scale and Functional Recovery Score, respectively, for 52 weeks after fracture. Health, cognitive, and psychosocial variables were gathered at baseline. We modeled depressive symptoms using group-based trajectory analysis and subsequently identified correlates of trajectory group membership. Results Three trajectories emerged according to the course of depressive symptoms, which we termed ‘resilient’, ‘distressed’, and ‘depressed’. The depressed trajectory (10% of participants) experienced a persistently high level of depressive symptoms and a slower time to recover mobility than the other trajectory groups. Stressful life events prior to the fracture, current smoking, higher anxiety, less social support, antidepressant use, past depression, and type of implant predicted membership of the depressed trajectory. Conclusions Depressive symptoms arising after hip fracture are associated with poorer functional status. Clinical and psychosocial variables predicted membership of the depression trajectory. Early identification and intervention of patients in a depressive trajectory may improve functional outcomes after hip fracture.

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“…To our knowledge, only two studies have reported exclusively on depressive symptoms developing post-fracture (Lenze et al . 2007; Oude Voshaar et al . 2007).…”

Section: Introductionmentioning

confidence: 99%

Trajectories of depressive symptoms after hip fracture

et al. 2016

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“…Delirium is reported in 16%Y62% of patients after surgery for hip fracture, 4,18 whereas depression is reported in 9%Y47%. 4,19 In this study, depression was present in 45.5% of the patients; and delirium, in 10%. These data are in line with those of the literature.…”

Section: Discussionmentioning

confidence: 89%

“…16), and irritability (j0. 19). At the end of rehabilitation, 69.2% of the patients with neuropsychiatric symptoms returned home vs. 62.7% of the patients without neuropsychiatric symptoms (P = 0.399).…”

Section: Functional Outcomesmentioning

confidence: 88%

Neuropsychiatric Symptoms and Rehabilitation Outcomes in Patients with Hip Fracture

Gialanella

Prometti

Monguzzi

et al. 2014

American Journal of Physical Medicine &Amp; Rehabilitation

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“…Further, postoperative pain is one of the strongest independent risk factors for incident depression and the latter was associated with a less favorable outcome at 3 months follow-up, which is again related to the level of pain. 28 Pain intensity is strongly negatively associated with both domestic and social functioning. Increases in pain intensity between 6 and 12 months were also associated with concurrent decreases in function, suggesting that pain relief must be adequately treated and maintained to sustain recovery.…”

Section: Discussionmentioning

confidence: 99%

A Prospective Review of Hip Fracture Subtypes, Surgical Procedure, Cognitive Status, and Analgesia Use Across 4 Australian Hospitals

Mak

Lattouf

Narushevich

et al. 2011

Geriatr Orthop Surg Rehabil

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Objectives: To correlate analgesia use among patients with hip fracture requiring surgery with hip fracture subtype, cognitive status, and type of surgery in the postacute period. Design and Participants: Prospective review of patients with hip fractures requiring surgical intervention. A total of 415 patients (mean age: 81.2 + 9.1 years, 74.3% women) presented with 195 subcapital fractures (39 undisplaced, 156 displaced) and 220 trochanteric fractures (136 stable, 84 unstable) requiring surgery. Setting: Inpatient orthopedic units in 4 Australian hospitals. Measurements: The primary outcome measures were mean analgesia usage (oral morphine equivalent) for 4 defined time intervals and total amount 36 hours following surgery. Results: Patients with subtrochanteric fractures required more analgesia compared with displaced-subcapital, undisplacedsubcapital, basicervical, stable-pertrochanteric, and unstable-pertrochanteric fractures in the 24 to 36 hours following operation (24.7 vs 11.3 vs 8.8 vs 12.1 vs 7.6 vs 9.7, P ¼ .001). Total analgesia requirements were higher in patients treated with an intramedullary nail, increasing by 1.3-to 3.3-fold in the 36 hours postsurgery. Patients with cognitive impairment utilized markedly less analgesia at all time periods measured. At 24 to 36 hours, higher levels of analgesia were noted in patients with higher premorbid level of mobility (P ¼ .015) and activities of daily living function (P ¼ .007). Conclusion: Important differences in utilization of analgesia following hip fracture across readily defined clinical groups exist. Proactive pain management for those with cognitive impairment, certain hip fracture subtypes, and surgical procedures may enable early functional mobility and other activities.

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Predictors of Incident Depression After Hip Fracture Surgery

Cited by 40 publications

References 26 publications

Trajectories of depressive symptoms after hip fracture

Trajectories of depressive symptoms after hip fracture

Neuropsychiatric Symptoms and Rehabilitation Outcomes in Patients with Hip Fracture

A Prospective Review of Hip Fracture Subtypes, Surgical Procedure, Cognitive Status, and Analgesia Use Across 4 Australian Hospitals

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