The Impact of Preoperative Chronic Pain on Postoperative Depressive States in Elderly Patients Undergoing Joint Replacement Surgery: A Secondary Analysis Based on Prospective Data

NCT07403838 | Completed

• 1 other identifier: PLAGH-PSD-001
• Study Type: observational
• Target: 575
• Locations: 1 country
• Sites: 1

Brief Summary

Background: Postoperative depression is a significant complication that hinders recovery in elderly patients undergoing joint replacement surgery. Although preoperative chronic pain is common in this population and pain and depression frequently coexist, the predictive role and underlying mechanisms of preoperative chronic pain on postoperative depression remain unclear. This study aims to systematically explore the association between the two, providing a basis for optimizing perioperative management and improving patient outcomes. Methods: This study is a secondary analysis of multicenter prospective data, including elderly patients who underwent elective knee or hip replacement surgery between April 2020 and April 2022 from a perioperative database of elderly patients in China. The impact of preoperative chronic pain on the occurrence of depressive states within 7 days after surgery was systematically evaluated using univariate and multivariate logistic regression analysis, propensity score matching, and subgroup analysis.

Conditions

Postoperative Depression

Keywords

Postoperative Depression Chronic Pain Elderly Patients Joint Replacement; Postoperative Depressive Symptoms; Postoperative Acute Pain; Preoperative Chronic Pain; Elderly

Outcome Measures

Primary Outcomes (1)

• Incidence and Severity Classification of Postoperative Depressive States (within 7 days)

  Postoperative depressive states were assessed using the Chinese version of the Patient Health Questionnaire-9 (PHQ-9). This scale was administered at bedside within 7 days after surgery by trained researchers. It is a self-reported tool comprising 9 items and is widely used for the efficient screening of clinical depressive symptoms. The assessment results were interpreted as follows: a total score ≥ 5 indicated the presence of a postoperative depressive state, with scores of 5-9 classified as mild, 10-14 as moderate, and 15-27 as moderately severe to severe.

  within 7 days after surgery

Eligibility Criteria

• Age: 65 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

This study is a secondary analysis based on a multicenter prospective database. We included 881 elderly patients who underwent elective joint replacement surgery at multiple medical centers between April 2020 and April 2022. The data were sourced from the Perioperative Database of Elderly Patients in China, which is a multicenter prospective study. The primary aim of this parent study was to identify perioperative risk factors in elderly patients undergoing non-cardiac surgery and to establish a targeted risk prevention and management system, utilizing data collected over a two-year period from 19 hospitals across the nation.

You may qualify if:

• Age ≥ 65 years.
• No cognitive impairment or history of mental illness.
• Underwent elective joint replacement surgery.
• Completed postoperative assessments, including questionnaires for depression, anxiety, and delirium.

You may not qualify if:

• Non-general anesthesia.
• Patients admitted to the intensive care unit postoperatively.
• Medical centers with fewer than 50 cases. -

Sponsors & Collaborators

• Chinese PLA General Hospital: lead
• The Affiliated Hospital Of Guizhou Medical University: collaborator

Study Sites (1)

Department of Anesthesiology, First Medical Center of the People's Liberation Army General Hospital

Beijing, Haidian, 100853, China

Location

Related Publications (3)

• Li L, Wu P, Wang Z, Meng X, Zha C, Li Z, Qi T, Zhang Y, Han B, Li S, Jiang C, Zhao Z, Cai J. NoncoRNA: a database of experimentally supported non-coding RNAs and drug targets in cancer. J Hematol Oncol. 2020 Feb 28;13(1):15. doi: 10.1186/s13045-020-00849-7.

  PMID: 32111231 RESULT

• Ninova M, Ronshaugen M, Griffiths-Jones S. Conserved temporal patterns of microRNA expression in Drosophila support a developmental hourglass model. Genome Biol Evol. 2014 Aug 27;6(9):2459-67. doi: 10.1093/gbe/evu183.

  PMID: 25169982 RESULT

• Thomson KH, Rantala MH, Viita-Aho TK, Vainio OM, Kaartinen LA. Condition-based use of antimicrobials in cats in Finland: results from two surveys. J Feline Med Surg. 2009 Jun;11(6):462-6. doi: 10.1016/j.jfms.2008.10.005. Epub 2008 Dec 25.

  PMID: 19111491 RESULT

Related Links

• Related Info

MeSH Terms

Conditions

Pain, Postoperative

Condition Hierarchy (Ancestors)

Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Pain; Neurologic Manifestations; Signs and Symptoms

Study Officials

• Li TONG TONG, PHD

  Department of Anesthesiology, The First Medical Center of Chinese PLA General Hospital

  PRINCIPAL INVESTIGATOR

• Weidong MI Mi, PHD

  Department of Anesthesiology, The First Medical Center of Chinese PLA General Hospital

  STUDY DIRECTOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Director of the Department of Anesthesiology, The First Medical Center of Chinese PLA General Hospital

Study Record Dates

• First Submitted: February 1, 2026
• First Posted: February 11, 2026
• Study Start: April 30, 2022
• Primary Completion: April 30, 2024
• Study Completion: April 30, 2024
• Last Updated: February 11, 2026

Record last verified: 2026-02

Data Sharing

• IPD Sharing: Will not share

Locations

CN (1)