Preoperative Symptoms of Depression are Associated with Worse Capability 6-weeks and 6-months After Total Hip Arthroplasty for Osteoarthritis.

Depression Mental Health Patient-Reported Outcome Measures THA Value-Based Health Care

Journal

The Journal of arthroplasty
ISSN: 1532-8406
Titre abrégé: J Arthroplasty
Pays: United States
ID NLM: 8703515

Informations de publication

Date de publication:
18 Apr 2024
Historique:
received: 16 09 2023
revised: 07 04 2024
accepted: 12 04 2024
medline: 21 4 2024
pubmed: 21 4 2024
entrez: 20 4 2024
Statut: aheadofprint

Résumé

Symptoms of depression have been associated with greater incapability following total hip arthroplasty (THA). A brief, 2-question, measure of symptoms of depression - the Patient Health Questionnaire 2 (PHQ-2) - may be sufficient to measure associations with the magnitude of incapability during recovery from THA. This study investigated whether preoperative symptoms of depression (measured with the PHQ-2) correlated with levels of incapability 6 weeks and 6 months after THA, accounting for demographic and clinical factors. We performed a prospective cohort study across 5 centers and recruited 101 patients undergoing THA, of whom 90 (89%) completed follow-up. Patients completed demographics, a pre-operative two-item (PHQ-2) measure of symptoms of depression, and the Hip Dysfunction and Osteoarthritis Outcome Score for Joint Replacement HOOS JR at 6-weeks and 6-months postoperatively. Negative binomial regression models determined factors associated with HOOS JR at 6 weeks and 6 months, accounting for potential confounders. Accounting for potential confounding factors, we found that higher preoperative PHQ-2 scores (reflecting greater symptoms of depression) were associated with lower HOOS JR scores (reflecting a greater level of hip disability) at both 6 weeks (Regression Coefficient (RC) = -0.67, P < 0.001) and 6 months (RC = -1.9, P < 0.001) after THA. Symptoms of depression on a 2-question pre-operative questionnaire are common, and greater symptoms of depression are associated with reduced capability within the first year following THA. These findings support the prioritization of routine mental health assessments before THA. Measuring mindset using relatively brief instruments will be important considering the current shift toward implementing self-reported measures of health status in clinical practice and incorporating them within alternative payment models.

Sections du résumé

BACKGROUND BACKGROUND
Symptoms of depression have been associated with greater incapability following total hip arthroplasty (THA). A brief, 2-question, measure of symptoms of depression - the Patient Health Questionnaire 2 (PHQ-2) - may be sufficient to measure associations with the magnitude of incapability during recovery from THA. This study investigated whether preoperative symptoms of depression (measured with the PHQ-2) correlated with levels of incapability 6 weeks and 6 months after THA, accounting for demographic and clinical factors.
METHODS METHODS
We performed a prospective cohort study across 5 centers and recruited 101 patients undergoing THA, of whom 90 (89%) completed follow-up. Patients completed demographics, a pre-operative two-item (PHQ-2) measure of symptoms of depression, and the Hip Dysfunction and Osteoarthritis Outcome Score for Joint Replacement HOOS JR at 6-weeks and 6-months postoperatively. Negative binomial regression models determined factors associated with HOOS JR at 6 weeks and 6 months, accounting for potential confounders.
RESULTS RESULTS
Accounting for potential confounding factors, we found that higher preoperative PHQ-2 scores (reflecting greater symptoms of depression) were associated with lower HOOS JR scores (reflecting a greater level of hip disability) at both 6 weeks (Regression Coefficient (RC) = -0.67, P < 0.001) and 6 months (RC = -1.9, P < 0.001) after THA.
CONCLUSION CONCLUSIONS
Symptoms of depression on a 2-question pre-operative questionnaire are common, and greater symptoms of depression are associated with reduced capability within the first year following THA. These findings support the prioritization of routine mental health assessments before THA. Measuring mindset using relatively brief instruments will be important considering the current shift toward implementing self-reported measures of health status in clinical practice and incorporating them within alternative payment models.

Identifiants

DOI: 10.1016/j.arth.2024.04.044 PMID: 38642851
pubmed: 38642851
pii: S0883-5403(24)00367-X
doi: 10.1016/j.arth.2024.04.044
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024. Published by Elsevier Inc.

Auteurs

Nicholas Sauder (N)

Dell Medical School at the University of Texas at Austin 1701 Trinity Street Austin, TX 78712, USA. Electronic address: nxs641@case.edu.

Niels Brinkman (N)

Dell Medical School at the University of Texas at Austin 1701 Trinity Street Austin, TX 78712, USA.

George E Sayegh (GE)

Dell Medical School at the University of Texas at Austin 1701 Trinity Street Austin, TX 78712, USA.

Meredith Grogan Moore (M)

Dell Medical School at the University of Texas at Austin 1701 Trinity Street Austin, TX 78712, USA.

Karl Koenig (K)

Dell Medical School at the University of Texas at Austin 1701 Trinity Street Austin, TX 78712, USA.

Kevin Bozic (K)

Dell Medical School at the University of Texas at Austin 1701 Trinity Street Austin, TX 78712, USA.

Jay Patel (J)

Hoag Orthopaedic Institute, Orange, California 280 South Main Street, Suite 200, Orange, CA 92868.

Prakash Jayakumar (P)

Dell Medical School at the University of Texas at Austin 1701 Trinity Street Austin, TX 78712, USA.

Classifications MeSH