Persistent pain and depression after hip fracture strongly correlate with poor outcomes

• Published in: European orthopaedics and traumatology Vol. 6; no. 4; pp. 399 - 404
• Main Authors: Pidemunt, G., Pérez-Prieto, D., Ginés-Cespedosa, A., Suils-Ramon, J., Puig-Verdié, L., Cáceres, E., Vilà-Canet, G.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.12.2015
• Subjects: Conservative Orthopedics; Medicine; Medicine & Public Health; Original Article; Orthopedics; Sports Medicine; Surgical Orthopedics; Traumatic Surgery; Depression; Hip fracture; Pain; Elderly; Quality of life
• ISSN: 1867-4569; 1867-4577
• DOI: 10.1007/s12570-015-0333-z

Background For some time, depressive symptoms have been correlated with worse outcomes in the elderly after hip fractures. However, the relationship between pain and functional outcomes has been less studied. Material and Methods The Short Form 36 (SF-36), the Harris Hip Score (HHS), the Geriatric Depression Scale (GDS), and the Barthel Index (BI) were analyzed. A total of 126 correlative patients with a hip fracture were included. After exclusion criteria and missing people, 100 patients were thoroughly evaluated at baseline, 3-month, and 1-year follow-up. Results The patients generally did not return to enjoy their previous quality of life, functioning, and autonomy after the fracture. Their GDS worsens from 4.39 points to 5.49 ( p  < 0.001) at 1-year follow-up. Bodily pain decreases throughout the follow-up from 67.33 points to 54.29 points. The remaining items studied started improving from the third month. Pain has a significant ( p  < 0.001) correlation with both the GDS ( ρ  = −0.58) and the Mental Composite Scale (MCS) of the SF-36 ( ρ  = 0.58) at 1 year follow-up. Conclusion The presence of pain and depressive symptoms is associated with worsened quality of life and functional outcomes. Multimodal pain and depression treatment might be a promising tool to mitigate it.