Comorbid tobacco and other substance use and symptoms of anxiety and depression among hospitalised orthopaedic trauma patients

Abstract

BackgroundNo study has examined the prevalence of tobacco, other substance use, and symptoms of anxiety and depression, and rates of comorbidities among the orthopaedic trauma population, despite the impact they have on recovery from surgery. This study aims to 1) describe the rates of symptoms and substance use; 2) compare rates of symptoms and substance use among smokers versus non-smokers; and 3) examine the relationship between symptoms and substance use with smoking status.MethodsA cross-sectional survey of orthopaedic trauma patients was conducted in two Australian public hospitals. Demographic characteristics, smoking status, alcohol consumption, recent cannabis use, and symptoms of anxiety and/or depression were examined. Differences between current and non-smokers were compared using Pearson Chi2 tests. Multivariate logistic regression explored variables related to tobacco smoking.ResultsEight hundred nineteen patients participated. Over one-fifth (21.8%) identified as a current smoker, half (51.8%) reported consuming alcohol at hazardous levels in the last 12 months, and about 10% stated that they had used cannabis in the last 30 days (9.7%), or experienced symptoms of either anxiety (12.4%), or depression (12.9%) in the last two weeks. Over one-fifth of current tobacco smokers (21.8%) reported drinking heavily in the last 12 months and using cannabis recently. Males, with a lower educational attainment, who were unmarried, had used cannabis recently, and report drinking heavily were more likely to be current smokers.ConclusionsHealth behaviour interventions addressing comorbidities are warranted among the orthopaedic trauma population given the high rate of comorbidity and impact these may have on recovery.Electronic supplementary materialThe online version of this article (10.1186/s12888-019-2021-y) contains supplementary material, which is available to authorized users.

Subphenotyping depression using machine learning and electronic health records

“…Strong associations exist between depression and anxiety and previous studies have suggested that more than 50% of patients with an anxiety disorder had depression 32 . An association between tobacco use and depression has also been shown by multiple previous studies 33‐35 and cigarette use was positively associated with depressive symptoms among young people such as college students 36 . Phenotype_B (n = 4687; 52.65%) included most patients (mean (SD) age, 68.44 (19.09) years) in our study.…”

Prevalence and association of anxiety and depression among orthopaedic trauma inpatients: a retrospective analysis of 1994 cases

“…In fact, drastic physical changes, strange hospital environment and uncertainty of post-injury recovery affect patients' psychology. Anxiety and depression in orthopaedic trauma patients have been reported to range between 5-35% and 13-56%, respectively [1][2][3]. Some studies have found that emotional disorder (anxiety or depression) was associated with factors such as pain, nuclear family, female sex [4], severity of injury [5], a younger age, lack of social support and use of cannabis [6,7].…”

What is the likely impact on surgical site infections in Australian hospitals if smoking rates are reduced? A cost analysis

“…Smoking rates tend to be higher in surgical populations compared with the general population [ 31 ]. In the last 10 years, three Australian studies have reported smoking rates in orthopaedic trauma [ 26 , 27 ] and acute fracture patients [ 28 ] between 19.6% and 32.8%. Older evidence suggested smoking rates in surgical patients could be as high as 38% [ 28 ].…”