Citation

Muscatelli S, Spurr H, O'Hara NN, O'Hara LM, Sprague SA, Slobogean GP. J. Orthop. Trauma 2016; ePub(ePub): ePub.

Affiliation

1University of Maryland School of Medicine, 655 West Baltimore Street, Baltimore, Maryland 2Graduate Entry Medicine, Royal College of Surgeons in Ireland, 123 St Stephens Green, Dublin, Ireland 3Department of Orthopaedics, University of Maryland School of Medicine, 6th Floor, Suite 300, 110 S. Paca Street, Baltimore, Maryland 4Department of Epidemiology and Public Health, University of Maryland School of Medicine, 685 West Baltimore Street, Baltimore, Maryland 5Division of Orthopaedic Surgery, Department of Surgery, McMaster University, 293, Wellington Street North, Suite 110, Hamilton, Ontario 6Department of Clinical Epidemiology and Biostatistics, McMaster University, 293 Wellington, Street North, Suite 110, Hamilton, Ontario.

Copyright

(Copyright © 2016, Lippincott Williams and Wilkins)

DOI

10.1097/BOT.0000000000000664

PMID

27465200

Abstract

OBJECTIVES: This study aims to systematically assess the existing literature and to derive a pooled estimate of the prevalence of depression and post-traumatic stress disorder (PTSD) in adult patients following acute orthopaedic trauma. DATA SOURCES: A comprehensive search of databases including MEDLINE, Embase, PsycINFO, and Cochrane Central Register of Controlled Trials (CENTRAL) databases was conducted through June 2015. STUDY SELECTION: We included studies that assessed the prevalence of depression or PTSD in patients who experienced acute orthopedic trauma to the appendicular skeleton or pelvis. Studies with a sample size of ≤ 10 were excluded. DATA EXTRACTION: Two authors independently extracted data from the selected studies and the data collected were compared to verify agreement. DATA SYNTHESIS: Twenty-seven studies and 7,109 subjects were included in the analysis. Using a random effects model, the weighted pooled prevalence of depression was 32.6% (95% CI: 25.0 - 41.2%) and the weighted pooled prevalence of PTSD was 26.6% (95% CI: 19.0 - 35.9%). Six studies evaluated the prevalence of both depression and PTSD in patients with acute orthopaedic injuries. The weighted pooled prevalence of both depression and PTSD for those patients was 16.8% (95% CI: 9.0 - 29.4%).

CONCLUSIONS: Nearly one-third of patients suffer from depression and over one-quarter of patients suffer from PTSD following an acute orthopaedic injury suggesting that strategies to address both the mental and physical rehabilitation following an orthopaedic injury should be considered to optimize patient recovery. LEVEL OF EVIDENCE: Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Language: en