Prevalence and Risk Factors of Perceived Stress in Elderly Patients With Osteoporotic Fractures of Spine.

Abstract

A retrospective cohort study. To investigate the point prevalence and risk factors of perceived stress in elderly patients with osteoporotic spinal fractures. Osteoporotic fractures, common in the elderly, are often complicated by stress-related psychological factors, which can affect recovery outcomes. However, the specific impact of perceived stress on these fractures remains underexplored. This study included 190 elderly patients with osteoporotic spinal fractures, of whom 43 (22.6%) were diagnosed with perceived stress and 147 (77.4%) were in the nonperceived stress group at The First Affiliated Hospital of the University of Science and Technology of China between January 1, 2020 and September 20, 2021. Patients were assessed for perceived stress using the Chinese 14-item Perceived Stress Scale (PSS). Sociodemographic and disease characteristics were evaluated, and the incidence of refracture and kyphosis was compared between patients with and without perceived stress. Statistical analyses included χ2 tests and binary logistic regression. Univariate analysis identified pain, gender, living alone, personality type, monthly family income, and prognosis expectations as significant factors associated with perceived stress (P<0.05). Multivariate analysis indicated that living alone (OR=321.176, 95% CI: 41.489-2486.319), low monthly family income (OR=291.667, 95% CI: 28.645-2969.798), introversion (OR=356.188, 95% CI: 72.770-1743.438), poor prognosis expectations (OR=2.791, 95% CI: 0.745-10.457), traumatic history (OR=194.750, 95% CI: 42.492-892.579), and intense pain (OR=6.857, 95% CI: 3.458-13.598) were significant risk factors (OR>1) for perceived stress. Patients with perceived stress had a higher incidence of refracture and kyphosis (P<0.05). Female gender, living alone, low family income, introversion, intense pain, and poor prognosis expectations are significant risk factors for perceived stress in elderly patients with osteoporotic fractures. Perceived stress is also linked to a higher incidence of local kyphosis and refractures. Individualized treatment plans integrating psychosocial care are essential for optimizing recovery in this patient population.