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Table 3 Study’s Results

From: Prognostic factors of depression and depressive symptoms after hip fracture surgery: systematic review

Author, year

Analysis

Effect Estimate/Result

Proposed Mechanism

Bruggeman 2007, Australia [28]

Hierarchical multivariable regression

Adjusted R2, Overall Model F

Personal control predicting Depression: 0.43, F (4, 52)

Personal control and hopelessness predicting depression: 0.55, F (5, 46)

Personal control beliefs predicted depression severity when entered alone, this relationship became nonsignificant when hopelessness scores were entered

Depression at T1 and pain at time T2 were significant predictors of depression

N

Cristancho 2016, USA [15]

Multinomial logistic regression model

Odds Ratio

Age: 1.04 (0.98–1.10)

Antidepressant use: 4.61 (1.46–14.61)

Anxiety traits: 1.49 (1.25–1.78)

CIRS-G co-morbidities: 1.05 (0.92–1.20)

FRS mobility score: 1.02 (0.89–1.17)

GALES stress rating: 1.38 (1.17–1.64)

Gender 0.39 (0.12–1.26)

Implant: type – internal fixation with screws: 2.75 (0.77–9.77)

Implant type – sliding hip screw – IM nail, other: 7.94 (2.31–27.31)

History of depression: 4.02 (1.13–14.28)

Pain rating scale: 1.09 (0.92–1.30)

SBT cognitive score: 1.07 (0.91–1.24)

Smoking status – current: 5.11 (1.09–24.00)

Smoking status – past: 1.67 (0.52–5.31)

Social network: 1.09 (0.98–1.22)

Subjective support: 1.39 (1.12–1.72)

N

Deng, 2005, Taiwan [29]

Logistic regression

Odds Ratio

Gender: 5.486 (2.088–14.416)

Complete cognition: 0.434 (0.143–1.321)

Fixed residence: 0.482 (0.099–2.338)

Dependent physical function before fracture: 6.021 (2.034–137.823)

Supporting system: 0.981 (0.940–1.023)

Y

Langer 2015, USA [30]

Auto-regressive latent trajectory (ALT) analyses

Fully standardized parameter used (no further description given)

Depression:

Negative affect intercept: 0.48

Negative affect slope: 0.56

Slower decline in negative affect predicted higher depression at Week 52

Y

Lenze, 2007, USA [13]

Repeated-measures mixed-effects model; Univariable and Multivariable Logistic Regressions

Odds Ratio

Univariate:

Age: 0.96 (0.91–1.01)

Male: 1.28 (0.34–4.81)

Cumulative Illness Rating Scale score: 0.98 (0.84–1.14)

Prefracture FIM motor subscale score: 1.01 (0.96–1.06)

Post fracture FIM motor subscale score: 1.01 (0.96–1.05)

Sub capital fracture: 0.65 (0.23–1.86)

Prosthetic joint surgery: 0.76 (0.26–2.17)

Surgical LOS: 1.04 (0.92–1.19)

Apathy Evaluation Scale score: 1.09 (1.03–1.16)

Delirium Rating Scale score: 1.07 (0.99–1.16)

MMSE: 1.01 (0.88–1.15)

Logical Memory Test score: 1.03 (0.89–1.19)

Mattis Initiation-Perseveration scale: 0.93 (0.83–1.04)

Social support: 0.97 (0.91–1.03)

Multivariate:

Apathy: 1.09 (1.02–1.15)

Delirium: 1.05 (0.96–1.15)

Individuals with clinical evidence of apathy are at high risk for developing MDD or depressive symptoms

N

Lenze, 2008, USA [31]

General linear regression models – time-adjusted model and covariate and time-adjusted model

Estimated mean difference

Covariate and time-adjusted model:

5HTR1A only: 0.66 (0.18, 1.14)

5HTR2A only: 0.44 (−0.10, 0.98)

5HTR1A and 5HTR2A combined:

5HTR1A: 0.61 (0.13, 1.09)

5HTR2A: 0.37 (− 0.16, 0.91)

The 5HTR1A promoter polymorphism is associated with depressive symptoms in elderly persons after a hip fracture. The G allele of the 5HTR1A (− 1019) polymorphism was associated with increased depressive symptoms for 12 months after the fracture

Y

Lenze, 2005, USA [32]

Repeated-measures analysis of variance

Only baseline data given

The s allele of the 5-HTTLPR is predictive of having MDD and high depressive symptoms after hip fracture

N

Liu 2018, Taiwan [33]

Binary logistic regression modelling

Coefficient estimate/b

Number of comorbidities: −0.27 (− 0.54, − 0.00)

Pre-fracture mobility: 0.11 (0.04, 0.18)

Other results not given

Patients were more likely to be in the progressively lower-risk group than in the fluctuating higher-risk group if they had fewer comorbidities or better prefracture mobility

N

Matheny, 2011, USA [34]

Generalized estimating equations (GEE)

Not given, only p-values

We found that hip fracture patients in the highest group of inflammatory cytokine levels for both IL-6 and sTNF-αR1 had higher levels of depressive symptoms than those in the lowest group, particularly at 12 months post fracture.

Y

Shyu 2009, Taiwan [10]

Multivariable logistic regression

Effect Estimates not given

Those who were female (P < 0.001), with lower prefracture performance of ADLs (P < 0.001) and with lower emotional-social support (P < 0.001) were more likely to be at higher risk for depressive symptoms.

Lower emotional-social support was the only predictor for persistent depressive symptoms after discharge

None of the predictors in the model were statistically significantly associated with depressive symptoms after discharge.

N

Van der Ree, 2020, Netherlands [14]

Univariable and Multivariable Logistic Mixed Model

Odds Ratio

Multivariable including frailty

Age ≥ 80 years: 1.61 (0.87–2.99)

Female gender: 0.87 (0.48–1.57)

ASA III/IV/V: 1.97 (0.94–4.12)

Prefracture residential status: 0.92 (0.29–2.90)

Prefracture mobility: With aid: 0.89 (0.44–1.78)

Dependent: 1.54 (0.46–5.13)

Type of fracture: extracapsular: 1.50 (0.85–2.65)

Length of hospital stay (days): 1.11 (1.04–1.20)

Discharge location: Institution: 2.20 (1.12–4.34)

Frailty: 2.74 (1.41–5.34)

Higher ASA scores, dependence in locomotion at baseline, longer LOS at hospital, and discharge to an institution were prognostic factors for symptoms of depression during 1 year after hip fracture

Frailty at onset of hip fracture was the most important prognostic factor of symptoms of depression on average in the year following hip fracture

N

Voshaar 2007, the Netherlands [35]

Cox proportional hazards model

Hazard Ratio

Postoperative pain: 1.32 (1.14–1.53)

Baseline anxiety: 1.25 (1.08–1.44)

The independent predictors that were associated with incident depression yielded postoperative pain and baseline anxiety as the strongest, independent risk factors

N