心理状态是脊柱狭窄症手术疗效的预测因素:整合患者满意度和功能结果的四象限模型。

IF 1.9 Q3 CLINICAL NEUROLOGY
Brain & spine Pub Date : 2024-09-07 eCollection Date: 2024-01-01 DOI:10.1016/j.bas.2024.103902
Judith van Grafhorst, Wouter van Furth, Carmen Vleggeert-Lankamp
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引用次数: 0

摘要

导言:以焦虑和抑郁为特征的精神状态会严重影响患者的身体健康,尤其是有椎管狭窄症状的患者:研究问题:我们的队列中抑郁和焦虑的流行率。心理困扰与术后身体状况(包括术后恢复和满意度)之间的相关性:向随机抽取的 450 名在 2007 年至 2013 年期间接受手术的腰椎管狭窄症患者(伴有或不伴有脊柱滑脱症)发送了评估焦虑和抑郁(HADS)、功能(ODI)、生活质量(EQ-5D)和感知恢复(Likert 量表)的问卷。研究结果按HADS得分(得分≥8分表示心理受损)进行二分法,并采用四象限模型对心理受损和未受损病例的功能结果和感知康复情况分别进行整合:在纳入的 147 名患者中,有 32 人(22%)表现出焦虑和/或抑郁(心理受损病例)。29.0%的心理受损病例和 78.3%的非心理受损病例(P 讨论和结论:与无障碍患者相比,焦虑和/或抑郁患者在椎管狭窄手术后的长期疗效较差。这一临床相关性差异强调了在术前咨询中解决抑郁和焦虑问题以优化患者满意度和功能预后的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Mental state as a predictor of outcome in spinal stenosis surgery: Four quadrants model integrating patient satisfaction and functional outcome.

Introduction: Mental status, characterised by anxiety and depression, significantly influences physical well-being, particularly in patients with spinal stenosis symptoms.

Research question: The prevalence of depression and anxiety in our cohort. The correlation between psychological distress and physical outcome after surgery, including postoperative recovery and satisfaction.

Materials and methods: Questionnaires evaluating anxiety and depression (HADS), functionality (ODI), quality of life (EQ-5D), and perceived recovery (Likert-scale) were sent to a randomly selected cohort of 450 lumbar spinal stenosis patients, with or without spondylolisthesis, who underwent surgery between 2007 and 2013. Results are presented, dichotomised by HADS score (score ≥8 indicating psychologically impaired) and in a Four Quadrants Model integrating functional outcomes and perceived recovery separately for psychologically impaired and non-impaired cases.

Results: Among the 147 included patients, 32 (22%) exhibited anxiety and/or depression (impaired cases). Satisfactory outcome (perceived recovery) was reported in 29.0% of the impaired cases and 78.3% of the non-impaired cases (p < 0.001). The mean postoperative functionality score of the impaired cases was 42.46 ± 16.24, in contrast to 18.48 ± 18.25 for the non-impaired cases (p < 0.001). In the impaired group, only 12.5% achieved both a good functional outcome (ODI ≤24) and satisfactory perceived recovery, compared with 58.4% in the non-impaired group.

Discussion and conclusion: Patients reporting anxiety and/or depression demonstrate an inferior long-term outcome after spinal stenosis surgery compared to non-impaired patients. This clinically relevant difference underscores the importance of addressing depression and anxiety in preoperative counselling to optimize patient satisfaction and functional outcomes.

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来源期刊
Brain & spine
Brain & spine Surgery
CiteScore
1.10
自引率
0.00%
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审稿时长
71 days
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