Evaluation of sleep disorder in orthopedic trauma patients: a retrospective analysis of 1129 cases

Abstract Background In the trauma center wards, it is not unusual for patients to have sleep disorders, especially patients with an acute injury. Meanwhile, there is substantial evidence that sleep disorder is a predictor of depression and is an important feature of posttraumatic stress disorder. Me...

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Main Authors: Hai Yang, Yi-jia Liu, Jia-lu Ye, Li-hong Zhao, Ling-li Li, Xiao-ling Hou
Format: Article
Language:English
Published: BMC 2021-05-01
Series:Journal of Orthopaedic Surgery and Research
Subjects:
Online Access:https://doi.org/10.1186/s13018-021-02487-2
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author Hai Yang
Yi-jia Liu
Jia-lu Ye
Li-hong Zhao
Ling-li Li
Xiao-ling Hou
author_facet Hai Yang
Yi-jia Liu
Jia-lu Ye
Li-hong Zhao
Ling-li Li
Xiao-ling Hou
author_sort Hai Yang
collection DOAJ
description Abstract Background In the trauma center wards, it is not unusual for patients to have sleep disorders, especially patients with an acute injury. Meanwhile, there is substantial evidence that sleep disorder is a predictor of depression and is an important feature of posttraumatic stress disorder. Methods All orthopedic trauma patients confined in a trauma ward in West China Hospital of Sichuan University between April 2018 and July 2019 were included in this retrospective study. Patients with mental impairment or craniocerebral injuries were excluded from the study. Basic demographic data and the Injury Severity Score (ISS) classification based on medical records were collected. The Pittsburgh sleep quality index (PSQI) was used to evaluate sleep quality, the visual analog scale (VAS) was used to evaluate physical pain, and the Barthel Index (BI) was used to evaluate activities of daily living (ADL). Univariate linear regression analysis and multivariate linear regression analysis were used to identify independently related factors. Results The average PSQI score was 6.3 (± 4.0). A total of 581 (51.4%) patients had a PSQI score > 5, indicating the presence of sleep disorders. The PSQI score was > 10 in 174 (15.4%) patients. Univariate statistical analysis showed that age, sex, education, ADL, and ISS classification were associated with increased PSQI scores. Marital status and pain were not associated with increased PSQI scores. When we used multivariate analysis to control for confounding variables, sex, ADL, and ISS classification remained independently associated with PSQI (P = 0.002, < 0.000, and 0.002, respectively). Conclusions In our study, sleep disorders were common (51.4% with PSQI > 5) and serious (15.4% with PSQI > 10) in patients with traumatic orthopedic injury. The following factors were closely associated with sleep disorders: sex, ADL, and ISS classification. Moreover, age and educational attainment have an independent impact on sleep quality. Unexpectedly, the VAS score for pain was not independently associated with the seriousness of sleep quality, which may be related to preemptive and multimodal analgesia. Further studies are required to clarify this ambiguity.
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spelling doaj.art-267fe3ce7f624f76af606e89f7700f5f2022-12-22T02:11:32ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2021-05-011611610.1186/s13018-021-02487-2Evaluation of sleep disorder in orthopedic trauma patients: a retrospective analysis of 1129 casesHai Yang0Yi-jia Liu1Jia-lu Ye2Li-hong Zhao3Ling-li Li4Xiao-ling Hou5Department of Orthopedics, West China Hospital of Sichuan UniversityDepartment of Orthopedics, West China Hospital of Sichuan UniversityMental Health Center, West China Hospital of Sichuan UniversityDepartment of Orthopedics, West China Hospital of Sichuan UniversityDepartment of Orthopedics, West China Hospital of Sichuan UniversityDepartment of Orthopedics, West China Hospital of Sichuan UniversityAbstract Background In the trauma center wards, it is not unusual for patients to have sleep disorders, especially patients with an acute injury. Meanwhile, there is substantial evidence that sleep disorder is a predictor of depression and is an important feature of posttraumatic stress disorder. Methods All orthopedic trauma patients confined in a trauma ward in West China Hospital of Sichuan University between April 2018 and July 2019 were included in this retrospective study. Patients with mental impairment or craniocerebral injuries were excluded from the study. Basic demographic data and the Injury Severity Score (ISS) classification based on medical records were collected. The Pittsburgh sleep quality index (PSQI) was used to evaluate sleep quality, the visual analog scale (VAS) was used to evaluate physical pain, and the Barthel Index (BI) was used to evaluate activities of daily living (ADL). Univariate linear regression analysis and multivariate linear regression analysis were used to identify independently related factors. Results The average PSQI score was 6.3 (± 4.0). A total of 581 (51.4%) patients had a PSQI score > 5, indicating the presence of sleep disorders. The PSQI score was > 10 in 174 (15.4%) patients. Univariate statistical analysis showed that age, sex, education, ADL, and ISS classification were associated with increased PSQI scores. Marital status and pain were not associated with increased PSQI scores. When we used multivariate analysis to control for confounding variables, sex, ADL, and ISS classification remained independently associated with PSQI (P = 0.002, < 0.000, and 0.002, respectively). Conclusions In our study, sleep disorders were common (51.4% with PSQI > 5) and serious (15.4% with PSQI > 10) in patients with traumatic orthopedic injury. The following factors were closely associated with sleep disorders: sex, ADL, and ISS classification. Moreover, age and educational attainment have an independent impact on sleep quality. Unexpectedly, the VAS score for pain was not independently associated with the seriousness of sleep quality, which may be related to preemptive and multimodal analgesia. Further studies are required to clarify this ambiguity.https://doi.org/10.1186/s13018-021-02487-2Orthopedic traumaSleep disorderSleepPittsburgh sleep quality index
spellingShingle Hai Yang
Yi-jia Liu
Jia-lu Ye
Li-hong Zhao
Ling-li Li
Xiao-ling Hou
Evaluation of sleep disorder in orthopedic trauma patients: a retrospective analysis of 1129 cases
Journal of Orthopaedic Surgery and Research
Orthopedic trauma
Sleep disorder
Sleep
Pittsburgh sleep quality index
title Evaluation of sleep disorder in orthopedic trauma patients: a retrospective analysis of 1129 cases
title_full Evaluation of sleep disorder in orthopedic trauma patients: a retrospective analysis of 1129 cases
title_fullStr Evaluation of sleep disorder in orthopedic trauma patients: a retrospective analysis of 1129 cases
title_full_unstemmed Evaluation of sleep disorder in orthopedic trauma patients: a retrospective analysis of 1129 cases
title_short Evaluation of sleep disorder in orthopedic trauma patients: a retrospective analysis of 1129 cases
title_sort evaluation of sleep disorder in orthopedic trauma patients a retrospective analysis of 1129 cases
topic Orthopedic trauma
Sleep disorder
Sleep
Pittsburgh sleep quality index
url https://doi.org/10.1186/s13018-021-02487-2
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