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Modelling the effect of minor orthopaedic day surgery on patient mood at the early post-operative period: A prospective population-based cohort study

Published online by Cambridge University Press:  16 April 2020

Evangelia M. Tsapakis ,
Eleftherios Tsiridis ,
Alistair Hunter ,
Zakareya Gamie ,
Nikolaos Georgakarakos ,
Panos Thomas ,
Constantin Schizas  and
Robert M. West
Evangelia M. Tsapakis
Affiliation:
Maudsley Hospital & Institute of Psychiatry, King’s College London, LondonSE5 8AF, UK
Eleftherios Tsiridis*
Affiliation:
Academic Unit of Trauma and Orthopaedics, Leeds Teaching Hospitals NHS Trust, Leeds School of Medicine, Leeds General Infirmary, Clarendon Wing A, Great George Street, LeedsLS1 3EX, UK
Alistair Hunter
Affiliation:
Department of Trauma and Orthopaedics, The Whittington Hospital, University College London, LondonN19 5NF, UK
Zakareya Gamie
Affiliation:
Academic Unit of Trauma and Orthopaedics, Leeds Teaching Hospitals NHS Trust, Leeds School of Medicine, Leeds General Infirmary, Clarendon Wing A, Great George Street, LeedsLS1 3EX, UK
Nikolaos Georgakarakos
Affiliation:
Department of Trauma and Orthopaedics, The Whittington Hospital, University College London, LondonN19 5NF, UK
Panos Thomas
Affiliation:
Department of Trauma and Orthopaedics, The Whittington Hospital, University College London, LondonN19 5NF, UK
Constantin Schizas
Affiliation:
Department of Trauma and Orthopaedics, The Whittington Hospital, University College London, LondonN19 5NF, UK
Robert M. West
Affiliation:
Biostatistics Unit, Centre for Epidemiology and Biostatistics, University of Leeds, LeedsLS2 9NL, UK
*
*Corresponding author. Tel./fax: +44 0113 3922621. E-mail address: etsiridis@doctors.org.uk
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Abstract

Objective

The effect of minor orthopaedic day surgery (MiODS) on patient’s mood.

Methods

A prospective population-based cohort study of 148 consecutive patients with age above 18 and less than 65, an American Society of Anaesthesiology (ASA) score of 1, and the requirement of general anaesthesia (GA) were included. The Medical Outcomes Study – Short Form 36 (SF-36), Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) were used pre- and post-operatively.

Results

The mean physical component score of SF-36 before surgery was 45.3 (SD = ±10.1) and 8 weeks following surgery was 44.9 (SD = ±11.04) [n = 148, p = 0.51, 95% CI = (−1.03 to 1.52)]. For the measurement of the changes in mood using BDI, BAI and SF-36, latent construct modelling was employed to increase validity. The covariance between mood pre- and post-operatively (cov = 69.44) corresponded to a correlation coefficient, r = 0.88 indicating that patients suffering a greater number of mood symptoms before surgery continue to have a greater number of symptoms following surgery. When the latent mood constructs were permitted to have different means the model fitted well with χ2 (df = 1) = 0.86 for which p = 0.77, thus the null hypothesis that MiODS has no effect on patient mood was rejected.

Conclusions

MiODS affects patient mood which deteriorates at 8 weeks post-operatively regardless of the pre-operative patient mood state. More importantly patients suffering a greater number of mood symptoms before MiODS continue to have a greater number of symptoms following surgery.

Keywords

Day surgeryOrthopaedicsDepressionAnxietyPost-operativeDSday surgeryMiODSminor orthopaedic day surgeryBAIBeck’s Anxiety InventoryBDIBeck’s Depression InventoryHESHospital Episode StatisticsFCEsfinished consultant episodesNHSNational Health ServiceASAAmerican Society of AnaesthesiologyGAgeneral anaesthesiaSF-36Short Form 36SDstandard deviationdfdegrees of freedom
Type
Original article
Information
European Psychiatry , Volume 24 , Issue 2 , March 2009 , pp. 112 - 118
Copyright
Copyright © Elsevier Masson SAS 2009

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