慢性腰腿痛患者微创术前焦虑,抑郁状态及相关影响因素分析

doi:10.19723/j.issn.1671-167X.2020.02.015

Abstract

Abstract:

Objective: To investigate anxiety and/or depression status of patients with chronic lumbocrural pain, and to further analyze related risk factors of anxiety and/or depression .Methods: Retrospective analysis of the medical data of patients who suffered from chronic lumbocrural pain caused by lumbar disc herniation and/or lumbar spinal stenosis and received minimally invasive surgery from March 2018 to April 2018. General data (including age, gender, education levels, past history, sleep order and medical insurance), numeric rating scale(NRS), Japanese Orthopedic Association(JOA) back pain scale and hospital anxiety and depression scale(HADS) were collected for analysis. The basic demographic data and clinic data were analyzed, possible related risk factors associated were analyzed by univariate analysis, and multivariate Logistic regression analysis was further used to find the relative independent risk factors and included all the predictive variables with P values less than 0.05 as covariates.Results: A total of 91 patients met the inclusion criteria and finished this study, the mean HADS score for anxiety was 8.1±4.2, 48(52.7%) respondents were screened positive for anxiety, while the rest 43(47.3%) patients had negative anxiety state, the mean HDDS score for depression was 6.9±4.9, 38(41.8%) respondents were screened positive for depression, and the rest 53(58.2%) patients were not depressed, and 56(61.5%) patients experienced anxiety or depression. There were significant difference in sleep disorder, JOA score and leg NRS score between the patients with and without anxiety(P<0.05), and the significant differences were also found in age, sleep disorder and JOA score between the patients with and without depression(P<0.05), Logistic regression analysis further showed that the JOA score and sleep disorder were risk factors for anxiety, and the JOA score was risk factor for depression.Conclusion: Patients with chronic lumbocrural pain are often accompanied by anxiety and/or depression before minimally surgery, the low JOA score and sleep disturbance increased the risk of presenting anxiety, and the low JOA score increased the risk of developing depression. It is necessary to evaluate mental status and related risk factors before surgery.

Key words: Lumbocrural pain, Minimally invasive, Anxiety, Depression, Risk factors

CLC Number:

R749.4

Duan YI,Wei ZHU,Xiu-li MENG,Xiao-guang LIU,Shui-qing LI,Bin ZHU,Dong-lin JIA. Analysis of anxiety, depression and related factors in patients with chronic lumbocrural pain before minimally invasive surgery[J].Journal of Peking University (Health Sciences), 2020, 52(2): 285-289.

Figures/Tables 2

Table 1

Univariable analysis of related variables associated with anxiety/depression for patients suffered from chronic lumbocrural pain"

Items	Anxiety			Depression
Items	Yes (n=48)	No (n=43)	P	Yes (n=38)	No (n=53)	P
Gender, n(%)
Male	23(47.9)	27(62.8)	0.206^a	19(50.0)	31(58.5)	0.522^a
Female	25(52.1)	16(37.2)		19(50.0)	22(41.5)
Age/years, $x ?$ ±s	54.8±17.2	52.9±19.8	0.636^b	60.0±15.7	49.5±19.1	0.006^b
Sleep disorder, n(%)
Yes	40(83.3)	21(48.8)	0.001^a	31(81.6)	30(56.6)	0.014^a
No	8(16.7)	22(51.2)		7(18.4)	23(43.4)
Diabetes, n(%)
Yes	7(14.6)	8(18.6)	0.778^a	8(21.1)	7(13.2)	0.394^a
No	41(85.4)	35(81.4)		30(78.9)	46(86.8)
CHD, n(%)
Yes	8(16.7)	3(7.0)	0.205^a	7(18.4)	4(7.5)	1.191^a
No	40(83.3)	40(93.0)		31(81.6)	49(92.5)
Hypertension, n(%)
Yes	13(37.1)	12(27.9)	1.000^a	13(34.2)	12(22.6)	0.243^a
No	35(62.9)	31(72.1)		25(75.8)	41(77.4)
Medical insurance, n(%)
Yes	9(18.8)	5(11.6)	0.408^a	5(13.2)	9(17.0)	0.108^a
No	39(81.2)	38(88.4)		33(86.8)	44(83.0)
Education levels, n(%)
Primary school	5(10.4)	2(4.6)	0.542^a	3(7.9)	4(7.5)	0.974^a
Junior middle school	8(16.7)	7(16.3)		6(15.8)	9(17.0)
Senior middle school	10(20.8)	10(23.3)		9(23.7)	11(20.8)
College	21(43.8)	16(37.2)		16(42.1)	21(39.6)
Above College	4(8.3)	8(18.6)		4(10.5)	8(15.1)
JOA score,$\bar{x}±s$	10.6±5.6	15.4±5.9	0.000^b	9.8±5.4	15.0±5.8	0.000^b
NRS score,$\bar{x}±s$
Lumbar	5.4±3.2	4.8±2.4	0.304^b	5.5±3.0	4.8±2.7	0.281^b
Leg	6.3±3.1	5.0±2.7	0.041^b	6.3±3.2	5.3±2.8	0.130^b

Table 1

Table 2

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Dependent variable	Independent variable	β	Wald	P	OR	R²
Anxiety
	JOA score	-0.114	7.105	0.008	0.892	0.200
	Sleep disorder	1.226	5.450	0.020	3.407
Depression
	JOA score	-0.156	13.623	<0.001	0.855	0.167

Analysis of anxiety, depression and related factors in patients with chronic lumbocrural pain before minimally invasive surgery

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