Occurrence and high risk factors of post-traumatic stress disorder related to orthopedic surgery / 中国组织工程研究

ABSTRACT

BACKGROUND: In recent years, with the continuous progress of orthopedic surgery technology and the rapid increase in the number of orthopedic surgery, more and more attention has been paid to the postoperative rehabilitation of patients. As a common mental disorder after orthopedic surgery, the occurrence of post-traumatic stress disorder is related to demographic characteristics, psychosocial factors, trauma characteristics, past mental status and perioperative cardiovascular indicators. At the same time, previous studies have shown that postoperative post-traumatic stress disorder is closely related to the rehabilitation of patients. OBJECTIVE: By consulting the related literature of post-traumatic stress disorder and postoperative rehabilitation after orthopedic surgery in recent years, this paper analyzed the occurrence, high risk factors and the relationship between post-traumatic stress disorder and postoperative rehabilitation after orthopedic surgery, in order to guide the early diagnosis and intervention of postoperative post-traumatic stress disorder. METHODS: The first author and the second author searched the related articles in PubMed database, Embase database, China National Knowledge Infrastructure(CNKI) and Wanfang database from January 1990 to October 2019 with the English key words of “orthopedic, surgery/operation, PTSD, risk factor, rehabilitation” and the Chinese words of “orthopedics, surgery, PTSD, high risk factors, rehabilitation”. A total of 94 articles were retrieved, of which 56 met the inclusion criteria. RESULTS AND CONCLUSION:(1) According to the type of operation, about 15%-40% of orthopedic patients may have varying degrees of post-traumatic stress disorder after surgery, and the incidence of post-traumatic stress disorder after lower limb amputation is highest.(2) Youth, female, low income, low education, lack of social support, high genetic susceptibility, poor psychological state before operation, poor psychological elasticity, hypotension, high heart rate and high pain sensitivity are all high risk factors for post-traumatic stress disorder after orthopedic surgery.(3) There is no clear correlation between the severity of preoperative trauma and the trauma of the operation itself and the occurrence of postoperative post-traumatic stress disorder, but the surgery with great influence on the ability of life and work after operation easily causes post-traumatic stress disorder.(4) Patients with postoperative post-traumatic stress disorder may have poor long-term prognosis.