Depression and anxiety are associated with worse baseline function in hip arthroscopy patients.

Abstract

The purpose of this study was to analyze the correlation between baseline depression and anxiety and preoperative functional status in hip arthroscopy patients. A prospective, institutional review board-approved orthopaedic registry was used to retrospectively study104patients undergoing hip arthroscopy. Enrolled patients were administered baseline questionnaires forPatient-Reported Outcomes Measurement Information System (PROMIS) domains,Musculoskeletal Outcomes Data Evaluation and Management System(MODEMS)preoperative expectations, and Numeric Pain Scale (NPS). The average baseline PROMIS Depression and Anxiety scores were49.9 ± 9.8and55.5 ± 9.3, respectively. Bivariate analysisdemonstratedthatgreaterbaseline PROMIS Anxiety correlated with worse preoperative PROMIS PI(p < 0.001), Fatigue(p < 0.001), Social Satisfaction(p < 0.001), andNPSscore(p = 0.013). Bivariate analysis showed thatgreaterPROMIS Depression correlated withworse preoperative PROMIS PF(p = 0.001), PI(p < 0.001), Fatigue(p < 0.001), SS(p < 0.001), andNPS score(p = 0.004). After controlling for confounders,multivariableanalysis confirmed increased PROMIS Depressionas an independent predictorof worse preoperative PROMIS PF(p = 0.009),MODEMS Expectations(p = 0.025), andNPS score(p = 0.002). Increased PROMIS Anxiety was predictive ofworsebaseline PROMIS PI(p < 0.001),Fatigue(p < 0.001), andSocial Satisfaction(p < 0.001). A previous clinical diagnosis of depression or anxiety wasonlyan independent predictor of worse baseline PROMIS Fatigue(p = 0.002) and was insignificant in all other models. Increasingseverity of depression and anxiety correlatedwith and predicted worse functional status at baseline in hip arthroscopy patients.As compared toclinical diagnosis of anxiety and depression, PROMIS metrics have superior utility in recognizingpotentially modifiable mental health concernsthatpredict worse preoperative status. Ultimately, the study identifies an at-risk population undergoing hip arthroscopy that requires particular attention and potential mental health intervention in the preoperative setting. III.