患者心理健康和其他心理因素在肩关节置换术结果中的作用：系统回顾和荟萃分析

Q4 Medicine

Seminars in Arthroplasty Pub Date : 2025-02-27 DOI:10.1053/j.sart.2025.01.007

Alexander J. MacFarlane MD , Tamari Bekauri BSc , Sonja Pavelseen MD, MS , M. Nadir Haider MD, PhD , Thomas R. Duquin MD

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引用次数: 0

摘要

背景：在下肢重建和全肩关节置换术中，抑郁和焦虑与患者预后差和较高不良事件相关。然而，这些结果可能是相互矛盾的。此外，抑郁和焦虑可能被认为是对患者心理健康和心理准备手术的不完全理解。除了抑郁和焦虑，我们还建议评估其他几个心理因素，包括躯体化、疼痛灾难化、恢复力、自我效能和运动恐惧症。方法系统检索PubMed、EMBASE和Cochrane数据库，检索时间自成立至2024年6月。采用纽卡斯尔-渥太华质量评估量表进行质量评估。通过比较情绪障碍（ED）对术前和术后美国肩肘外科医生（ASES）评分的影响进行meta分析。结果共纳入24篇文献。纽卡斯尔-渥太华质量评估量表的平均得分为6.63分（满分9分）。四篇文章被纳入meta分析。我们发现术前as评分（d = - 0.363 [- 0.733, 0.007], P = 0.055）与诊断或ED类型（0.210）或手术（0.506）无关。但术后as评分显著低于对照组(d = - 0.511 [- 0.722, - 0.300], P <；.001)，与ED类型（P = .671）或手术（P = .589）无关。在包括活动度（ROM）结果的7篇文章中，我们发现4篇文章支持活动度恶化，2篇文章支持活动度改善，1篇文章支持与ed相关的无差异。结论：根据我们的荟萃分析，全肩关节置换术后患者报告的预后较差与抑郁和焦虑有关。然而，关于ED对术后ROM的影响，我们发现了相互矛盾的证据。

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The role of patient mental health and other psychological factors in the outcomes of shoulder arthroplasty: a systematic review and meta-analysis

Background

Depression and anxiety have been associated with poor patient outcomes and higher adverse events in lower extremity reconstruction as well as total shoulder arthroplasty. However, these results can be conflicting. Additionally, depression and anxiety may be considered an incomplete understanding of a patient's mental health and mental readiness for surgery. We have proposed evaluating several other psychological factors in addition to depression and anxiety, which include somatization, pain catastrophizing, resilience, self-efficacy, and kinesiophobia.

Methods

We searched PubMed, EMBASE, and Cochrane systematically from inception until June of 2024. Newcastle-Ottawa Quality Assessment Scale was used for quality assessment. The meta-analysis was conducted by comparing the effects of emotional disorders (ED's) on preoperative and postoperative American Shoulder and Elbow Surgeons (ASES) score.

Results

A total of 24 articles were included in the final analysis. The mean Newcastle-Ottawa Quality Assessment Scale score was 6.63 of a possible 9 points. Four articles were included in the meta-analysis. We found no difference in the preoperative ASES score (d = −0.363 [−0.733, 0.007], P = .055) irrespective of diagnosis or type of ED (0.210) or procedure (0.506). However, postoperative ASES scores were statistically significantly lower (d = −0.511 [−0.722, −0.300], P < .001) for those with ED, independent of the type of ED (P = .671) or procedure (P = .589). Of the 7 articles included with range of motion (ROM) outcomes, we found 4 articles supporting worse ROM, 2 articles supporting improved ROM, and 1 article supporting no differences when associated with ED.

Conclusions

Depression and anxiety are linked to poorer patient-reported outcomes following total shoulder arthroplastybased on our meta-analysis. However, we found conflicting evidence regarding the effects of ED's on postoperative ROM.

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来源期刊

Seminars in Arthroplasty Medicine-Surgery

CiteScore

1.00

自引率

0.00%

发文量

104

期刊介绍： Each issue of Seminars in Arthroplasty provides a comprehensive, current overview of a single topic in arthroplasty. The journal addresses orthopedic surgeons, providing authoritative reviews with emphasis on new developments relevant to their practice.