Relationship between preoperative psychological stress and short-term prognosis in elderly patients with femoral neck fracture

Table 1 General data of patients in the poor and good prognosis groups

Data	Poor prognosis group (n = 28)	Good prognosis group (n = 92)	χ2/t	P value
Sex, n (%)			0.857	0.354
Male	6 (21.43)	28 (30.43)
Female	22 (78.57)	64 (69.57)
Age (mean ± SD, yr)	65.72 ± 4.39	66.35 ± 4.26
Body mass index (mean ± SD, kg/m2)	20.13 ± 2.29	20.06 ± 2.32
Complications, n (%)
Hypertension	6 (21.43)	20 (21.74)	0.001	0.972
Diabetes	5 (17.86)	18 (19.57)	0.040	0.841
Hyperlipidemia	3 (10.71)	15 (16.30)	0.179	0.672
Abnormal liver function	4 (14.29)	16 (17.39)	0.009	0.923
Fracture site, n (%)			0.186	0.666
left side	15 (53.57)	45 (48.91)
right side	13 (46.43)	47 (51.09)
Garden classification of FNF, n (%)			12.179	< 0.001
Type III	5 (17.86)	51 (55.43)
Type IV	23 (82.14)	41 (44.57)
Cause of fracture, n (%)			7.461	0.006
Low-energy damage	5 (17.86)	43 (46.74)
High-energy damage	23 (82.14)	49 (53.26)
FNF reduction quality, n (%)			10.645	0.005
Grade A	8 (28.57)	40 (43.48)
Grade B	5 (17.86)	32 (34.78)
Grade C	15 (53.57)	20 (21.74)
Operational conditions
Operation time (min)	108.62 ± 14.39	107.71 ± 15.02	0.283	0.777
Intraoperative blood loss (mL)	362.22 ± 25.68	359.31 ± 23.47	0.562	0.575
Intraoperative blood transfusion (mL)	283.36 ± 52.47	278.55 ± 55.36	0.407	0.685
Postoperative drainage volume (mL)	173.25 ± 49.62	171.24 ± 51.07	0.184	0.855
Length of hospital stay (d)	21.03 ± 4.71	17.03 ± 4.71	3.935	< 0.001
Intraoperative hypotension			0.076	0.783
Yes	13 (46.43)	40 (43.48)
No	15 (53.57)	52 (56.52)
Postoperative sarcopenia			0.758	0.384
Yes	10 (35.71)	25 (27.17)
No	18 (64.29)	67 (72.83)
Postoperative complications			0.149	0.699
Yes	6 (21.43)	23 (25.00)
No	22 (78.57)	69 (75.00)

FNF: Femoral neck fracture.

Table 2 Preoperative Symptom Checklist-90 scores of the poor and good prognosis groups

SCL-90	Poor prognosis group (n = 28)	Good prognosis group (n = 92)	t	P value
ANX	27.46 ± 3.35	24.17 ± 3.42	4.478	< 0.001
DEP	33.56 ± 2.34	30.25 ± 2.14	7.011	< 0.001
HOS	14.03 ± 2.51	14.72 ± 2.53	1.266	0.208
IS	16.12 ± 2.37	16.23 ± 2.25	0.224	0.823
OCD	17.36 ± 3.52	17.42 ± 3.37	0.082	0.935
PAR	16.13 ± 3.16	16.24 ± 2.88	0.173	0.863
PHOB	14.11 ± 2.58	14.06 ± 1.88	0.112	0.911
PSY	20.21 ± 3.46	20.17 ± 3.55	0.053	0.958
SOM	22.61 ± 3.18	19.23 ± 4.12	3.990	< 0.001

SCL-90: Symptom Checklist-90; ANX: Anxiety; DEP: Depression; HOS: Hostility; IS: Interpersonal sensitivity; OCD: Obsessive-compulsive disorder; PAR: Paranoid; PHOB: Phobia; PSY: Psychosis; SOM: Somatization.

Table 3 Correlation between indicators and prognosis of patients with Femoral neck fracture after surgery

Independent variables	B	SE	Wals	P value	OR (95%CI)
ANX	0.326	0.153	4.520	0.034	1.385 (1.026-1.870)
DEP	0.522	0.196	7.114	0.008	1.685 (1.148-2.472)
SOM	0.221	0.127	3.034	0.082	1.247 (0.973-1.599)
Garden classification of FNF	1.633	0.795	4.226	0.040	5.121 (1.079-24.303)
Cause of fracture	3.096	1.464	4.476	0.034	22.119 (1.256-389.623)
FNF reduction quality			6.931	0.031
Level A	2.523	1.361	3.436	0.064	12.470 (0.865-179.753)
Level B	-1.686	0.974	2.993	0.084	0.185 (0.027-1.251)
Length of hospital stay	0.260	0.089	8.564	0.003	1.297 (1.090-1.544)

FNF: Femoral neck fracture; ANX: Anxiety; DEP: Depression; SOM: Somatization; B: Regression coefficient; SE: standard error; OR: Odds ratio; CI: Confidence interval.

Table 4 Receiver operating characteristic curve analysis

Variables	AUC	P value	95%CI	Sensitivity	Specificity	Optimum cutoff value
ANX	0.742	< 0.001	0.641-0.844	0.857	0.533	24.5
DEP	0.854	< 0.001	0.760-0.947	0.786	0.880	32.5
Garden classification of FNF	0.688	0.003	0.582-0.794	0.821	0.554	0.5
Cause of fracture	0.644	0.021	0.534-0.755	0.821	0.467	0.5
FNF reduction quality	0.648	0.018	0.524-0.772	0.536	0.783	2.5
Length of hospital stay	0.749	< 0.001	0.640-0.858	0.750	0.761	20.5

FNF: Femoral neck fracture; ANX: Anxiety; DEP: Depression; AUC: Area under the curve; CI: Confidence interval.

Table 5 Correlation between influence indicators and Harris score

Influence indicators		ANX	DEP	SOM	Garden classification of FNF	Cause of fracture	FNF reduction quality	Length of hospital stay
Harris scores	R	-0.523	-0.625	-0.554	-0.253	-0.250	-0.269	-0.222
	P value	< 0.001	< 0.001	< 0.001	0.005	0.006	0.003	0.015
ANX	R		0.455	0.489	0.084	0.141	0.205	0.092
	P value		< 0.001	< 0.001	0.363	0.124	0.025	0.316
DEP	R			0.495	0.207	0.169	0.219	0.148
	P value			< 0.001	0.023	0.065	0.016	0.107
SOM	R				0.158	0.080	0.202	0.227
	P value				0.084	0.384	0.027	0.013
Garden classification of FNF	R					0.225	0.199	0.073
	P value					0.013	0.029	0.428
Cause of fracture	R						0.621	0.161
	P value						< 0.001	0.079
FNF reduction quality	R							0.197
	P value							0.031

FNF: Femoral neck fracture; ANX: Anxiety; DEP: Depression; SOM: Somatization; R: correlation coefficient.