What is the clinical evidence from this study?

Study design: Cohort. Population: Hip fracture (n=482). Intervention: Depressed trajectory vs. Resilient trajectory. Primary outcome: Recovery of pre-fracture mobility score at 1 year (p=<0.001).

February 5, 2016Psychological MedicineOpen Access

Trajectories of depressive symptoms after hip fracture

Q: What are the key findings of this study?

Patients following a depressed trajectory after hip fracture recovered only 67% of their pre-fracture mobility at 1 year, compared to 88% recovery in the resilient group.

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Key result

Post-fracture depressed trajectory linked to only ~67% recovery of baseline mobility at one year.

P<0.001
n=482

Population

482 inpatients, aged ⩾60 years, admitted for hip fracture repair at eight St Louis, MO area hospitals…

Design

Cohort

Follow-up

52 weeks

Authors

PCPilar CristanchoWashington University in St. Louis ELEric J. LenzeTwitter (United States)MAMichael S. AvidanSemmelweis University

Discussion

Member takes

Implication

Persistent post-hip fracture depression links to poorer mobility recovery; leaves open whether screening or treatment improves outcomes.

Study Design

Type

Cohort (n=482)

Multicenter

Yes

Structured PICO

Population

482 inpatients, aged ⩾60 years, admitted for hip fracture repair at eight St Louis, MO area hospitals between 2008 and 2012. Excluded: current depression diagnosis and/or notable cognitive impairment.

Outcome

Trajectories of depressive symptoms (assessed with Montgomery-Asberg Depression Rating Scale) and functional recovery (Functional Recovery Score) for 52 weeks after fracturepatient reported

Main Result

Absolute Event Rate: 67% vs 88%

p-value: p=<0.001

Depressive symptoms after hip fracture follow distinct trajectories, with a persistently depressed group experiencing slower functional recovery.

Limitations

Information about falls was not included, limiting the ability to explore confounding effects related to falls.
Mobility was assessed using the participant's self-report from the Functional Recovery Score rather than an objective measure.
The use of a numerical pain rating scale limited the ability to explore different aspects of pain.
Difficulty in discerning causal inference in an observational study, as persistent disability and pain may have led to persistently elevated depressive symptomology.

Cite This Study

Cristancho et al. (2016) conducted a cohort in Hip fracture (n=482). Depressed trajectory vs. Resilient trajectory was evaluated on Recovery of pre-fracture mobility score at 1 year (p=<0.001). Patients following a depressed trajectory after hip fracture recovered only 67% of their pre-fracture mobility at 1 year, compared to 88% recovery in the resilient group.

synapsesocial.com/papers/6a0fc4c72badbc352afeaffd https://doi.org/10.1017/s0033291715002974

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Trajectories of depressive symptoms after hip fracture

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Trajectories of depressive symptoms after hip fracture

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Also Consider