Impact of anxiety during hospitalization on the clinical outcome of patients with osteoporotic thoracolumbar vertebral fracture: a prospective multicentric study

Abstract Background Anxiety in combination with osteoporotic vertebral compression fractures (OVCFs) of the spine remains understudied. The purpose of this study was to analyze whetheranxiety has an impact on the short-term functional outcome of patients with an OVCF. Furthermore, a direct impact of the fracture on the patient’s anxiety during hospitalization should be recognized. Methods A prospective multicentric study in a German-speaking area was performed. All inpatients with an OVCF of the thoracolumbar spine from 2017 to 2020 were included. Trauma mechanism, analgetic medication, anti-osteoporotic therapy, timed-up-and-go test (TuG), mobility, Barthel index, Oswestry-Disability Index (ODI) and EQ5D-5L were documented. For statistical analysis, the U test, chi-square independence test, Spearman correlation, General Linear Model for repeated measures, Bonferroni analysis and Wilcoxon test were used. The item anxiety/depression of the EQ5D-5L was analyzed to describe the patients’ anxiousness. Results Data from 518 patients from 17 different hospitals were evaluated. Fracture severity showed a significant correlation (r=0.087, p=0.0496) with anxiety. During the hospital stay, pain medication (p<0.001), anti-osteoporotic medication (p<0.001), and initiation of surgical therapy (p<0.001) were associated with less anxiety. The anxiety of a patient at discharge was negatively related to the functional outcomes at the individual follow-up: TuG (p<0.001), Barthel index (p<0.001), ODI (p<0.001) and EQ5D-5L (p<0.001). Conclusions Higher anxiety is associated with lower functional outcome after OVCF. The item anxiety/depression of the EQ5D-5L provides an easily accessible, quick and simple tool that can be used to screen for poor outcomes and may also offer the opportunity for a specific anxiety intervention.