Abstract
BACKGROUND: Hip fracture in elderly patients, particularly those with comorbid post-traumatic stress disorder (PTSD), presents a significant clinical challenge. In addition to the physiological stress of surgery, these patients often endure psychological burdens that may adversely affect postoperative recovery. The potential benefits of targeted perioperative psychological interventions have not been fully elucidated in this special population. This study hypothesized that a structured perioperative psychological program would improve recovery outcomes, including postoperative pain, functional outcomes, and mental well-being. AIM: To evaluate the impact of perioperative psychological intervention on postoperative outcomes among elderly patients with PTSD undergoing hip fracture surgery. METHODS: Between January 1, 2022, and December 31, 2024, medical records of 50 elderly hip fracture patients (age ≥ 65) with PTSD who underwent surgical fixation at our center were retrospectively reviewed. Patients were divided into an intervention (n = 25; standardized psychological care) and control (n = 25; usual care) groups. Data collected included demographics, fracture type, PTSD severity, and anesthesia details. The intervention comprised preoperative counseling, relaxation training, and postoperative coping sessions. Postoperative outcomes compared included pain, PTSD severity, activities of daily living scores, complications, length of stay, mental health, and functional recovery. RESULTS: The groups had comparable demographic and clinical characteristics. The intervention group demonstrated significantly lower pain scores on postoperative days 3 and 7 (P < 0.01), fewer moderate-to-severe depressive symptoms (P < 0.05), and a greater reduction in PTSD severity (P < 0.01) compared with the control group. Furthermore, the intervention group exhibited improved activities of daily living scores at 4 weeks post-surgery and a lower postoperative complication rate (16% vs 32%, P = 0.14). The average length of hospital stay was shorter in the intervention group (11.5 ± 2.0 days vs 13.1 ± 2.6 days, P < 0.05). CONCLUSION: In elderly hip fractures patients with comorbid PTSD, perioperative psychological interventions improved pain control, functional recovery, and PTSD symptoms, supporting its value in holistic perioperative management and outcome enhancement.