Influence of mental and psychological states on surgical outcomes following open reduction and internal fixation for trimalleolar ankle fractures

Table 4 Comparison between the two patient groups before the operation and at the last follow-up, median (interquartile range)

Variables		Pairing		Z	P value	Group difference (95%CI)	Effect size (95%CI)
		Preoperative	Last follow-up
Group A (n = 231)	VAS; HADS-A; HADS-D	63.00 (55.00, 70.00)	19.00 (12.00, 24.00)	-13.18	< 0.01	Med diff: 44.00 (42.00-46.00)	r: -0.61 (-0.55 to -0.66)
		8.00 (7.00, 9.00)	3.00 (3.00, 5.00)	-13.20	< 0.01	Med diff: 4.00 (4.00-5.00)	r: -0.61 (-0.66 to -0.56)
		7.00 (7.00, 9.00)	5.00 (3.00, 7.00)	-13.16	< 0.01	Med diff: 4.00 (3.00-4.00)	r: -0.61 (-0.65 to -0.56)
Group B (n = 236)	VAS; HADS-A; HADS-D	57.00 (49.00, 66.00)	8.00 (5.00, 12.00)	-13.32	< 0.01	Med diff: 48.00 (47.00-50.00)	r: -0.62 (-0.66 to -0.57)
		5.00 (4.00, 6.00)	2.00 (1.00, 2.00)	-13.29	< 0.01	Med diff: 3.00 (3.00-3.00)	r: -0.62 (-0.66 to -0.58)
		5.00 (3.00, 5.00)	1.00 (1.00, 2.00)	-12.82	< 0.01	Med diff: 3.00 (3.00-3.00)	r: -0.59 (-0.63 to -0.55)

CI: Confidence interval; VAS: Visual Analogue Scale; HADS-A: Hospital Anxiety and Depression Scale-Anxiety; HADS-D: Hospital Anxiety and Depression Scale-Depression; Med diff: Median difference; r: Rank-biserial correlation.