Factors Associated with Depression Among Patients with Femoral Fractures Treated at Muhimbili Orthopaedic Institute, Dar Es Salaam, Tanzania

Igoro, Emmanuel; Haonga, Billy T.; Kaaya, Sylvia F.; Hussein, Mohamed Muhamed

doi:10.21608/EOJ.2025.419271

Factors Associated with Depression Among Patients with Femoral Fractures Treated at Muhimbili Orthopaedic Institute, Dar Es Salaam, Tanzania

Document Type : Original Article

Authors

¹ Department of Orthopaedic and Traumatology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania and Maweni Regional Referral Hospital, Kigoma, Tanzania.

² Department of Orthopaedic and Traumatology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania and cMuhimbili Orthopaedic Institute, Dar es Salaam, Tanzania.

³ Department of Psychiatry and Mental Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.

⁴ Department of Orthopaedic and Traumatology, Muhimbili University of Health and Allied Sciences, Dar es Salaam and Ebrahim Haji Charitable Health centre, Dar es Salaam, Tanzania.

10.21608/EOJ.2025.419271

Abstract

Introduction
The occurrence of depression among patients with femoral fractures is overlooked and underestimated. Female sex, age, socioeconomic status, the severity of pain, and longer hospital stays are some of the factors that are associated with either developing or worsening of depression in patients with femoral fractures.
Objective
To determine factors associated with depression among patients with femoral fractures treated at Muhimbili Orthopaedic Institute from July 2018 to June 2019.
Subjects and Methods
This was a descriptive cross-sectional hospital-based study. Data collection was done using a structured questionnaire, which collected information about sociodemographics, pain severity prior to surgery, and depression using the nine items of the Patient Health Questionnaire. Fisher’s exact test was used to determine the significance of variations and odds ratios strength of association.
Results
One hundred and twenty-six patients who met the inclusion criteria were enrolled in this study. The mean duration from arrival to surgery was 10.4±14.3 days, with a pain severity (visual analog scale) score of 3.1±2.2 and Patient Health Questionnaire-9 of 2.5±4.4. The participants who developed depression were 16 (12.7%). Risk factors associated with depression were pain severity (p<0.001) and delayed time to surgery (p=0.003).
Conclusion
The prevalence of clinically significant depression was 12.7%. This study has shown a strong association between pain and duration of stay before surgery in the development of depression in patients with femoral fractures.

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