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Predictors of incident depression after hip fracture surgery . OBJECTIVE Depression after hip fracture surgery is prevalent and associated with increased mortality rates and impaired functional recovery . The incidence of new-onset depressive symptoms in patients initially not depressed after hip fracture surgery and their relationship with functional recovery is unknown . METHODS A cohort of 139 nondepressed elderly patients ( > 60 years ) hospitalized for hip fracture surgery were followed up for six months . Clinically significant depressive symptoms were defined as a score of 7 or more on the 15-item Geriatric Depression Scale . RESULTS The authors found a cumulative incidence rate of 20.5 % adjusted for dropouts . Multiple Cox-regression analyses yielded the presence of subthreshold symptoms of depression , anxiety , pain , and cognitive impairment at baseline , the premorbid level of mobility , and a history of ( treated ) depression as risk factors for incident depression ( p < 0.05 ) . A forward , conditional procedure identified postoperative pain ( hazard ratio [ HR ] = 1.32 , 95 % confidence interval [ CI ] : 1.14-1.53 , Wald chi ( 2 ) = 13.57 , df = 1 , p < 0.001 ) and baseline anxiety ( HR = 1.25 , 95 % CI : 1.08-1.44 , Wald chi ( 2 ) = 8.86 , df = 1 , p = 0.003 ) as the strongest independent risk factors . Incident depression was associated with a less favorable outcome at 3 months follow-up . CONCLUSION This exploratory study identified two treatable baseline characteristics that predicted incident depression in nondepressed patients after hip-fracture surgery .
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Intervention_Surgical
hip fracture surgery
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Intervention_Surgical
hip fracture surgery
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Intervention_Surgical
hip fracture surgery
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Outcome_Mental
incident depression
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Outcome_Mental
15-item Geriatric Depression Scale .
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Outcome_Mental
cumulative incidence rate
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Outcome_Mental
depression , anxiety
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Outcome_Pain
pain
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Outcome_Mental
cognitive impairment
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Outcome_Mental
depression as risk factors for incident depression
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Outcome_Pain
postoperative pain
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Outcome_Mental
baseline anxiety
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Outcome_Mental
Incident depression
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Outcome_Mental
incident depression
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Participant_Condition
hip fracture
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Participant_Sample-size
139
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Participant_Age
elderly
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Participant_Age
> 60 years
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Participant_Condition
hip fracture
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Participant_Condition
hip-fracture