Patients with PJI may demonstrate ‘alarmingly poor’ mental health
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Key takeaways:
- Patients with periprosthetic joint infection demonstrated a high prevalence of mental demoralization before and after surgery.
- A comprehensive psychosocial support program may benefit patients with infections.
Presented results showed patients with periprosthetic joint infection may demonstrate a high prevalence of mental distress from prolonged hospitalization, pain and physical disability.
“We would argue that there’s an urgent need for a comprehensive psychosocial support program for patients experiencing PJI both preemptively, early in treatment and potentially throughout the course of patient care,” Simon Garceau, MD, assistant professor in the department of surgery at the University of Ottawa, said during his presentation at the Musculoskeletal Infection Society Annual Meeting.
“Mental health of PJI patients is alarmingly poor, [with] the majority of PJI patients experiencing high demoralization and roughly half meeting the threshold for anxiety and/or depression,” Garceau added.
Garceau and colleagues performed a prospective observational study of 34 patients (mean age, 70.2 years) who presented with PJI of the hip (n = 17) or knee (n = 17) between November 2023 and April 2024.
Garceau and colleagues assessed the mental health of patients with several health-related quality of life (HRQoLs) surveys such as Oxford hip and knee scores, patient-reported outcomes, the EuroQol-5D-5L questionnaire, the patient health questionnaire-4 (PHQ-4) and the demoralization scale. They assessed outcomes preoperatively and at 5 days and 3 months after surgery for PJI.
Preoperatively, 47% of patients had anxiety, 52% had depression and 74% had demoralization. At 5 days postoperatively, 50% of patients had anxiety, 47% had depression and 87% had demoralization. At 3 months postoperatively, seven patients had complete HRQoLs, with 57% demonstrating demoralization. Garceau noted six patients refused to complete HRQoLs at 3 months.
“It’s crucial to consider that patients with this syndrome are at elevated risk of progressing to a desire to die or commit suicide,” Garceau said. “The high incidence of refusal to answer questionnaires [at] 3 months postoperatively may be indicative of significant mental distress that’s not captured. Reasons for refusal likely suggest that our results underreport the severity and prevalence of the problem.”
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Garceau S, et al. Paper 1354. Presented at: Musculoskeletal Infection Society Annual Meeting; Aug. 2-3, 2024; Durham, North Carolina (hybrid meeting).
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