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

Table 8 Comparison of changes in each evaluation index between the two groups of patients before surgery and at the last follow-up, mean ± SD/median (interquartile range)

Variables	VAS changes	HADS-A changes	HADS-D changes
Group A (n = 231)	41.85 ± 0.91	4.00 (3.00, 5.00)	3.00 (2.00, 4.00)
Group B (n = 236)	47.43 ± 0.84	3.00 (2.00, 4.00)	3.00 (2.00, 4.00)
t/Z	-4.34	-6.87	-4.70
P value	< 0.01	< 0.01	< 0.01
Group difference (95%CI)	MD: -5.58 (-8.02 to -3.13)	Med diff: 1.00 (1.00-1.00)	Med diff: 1.00 (0.00-1.00)
Effect size (95%CI)	Cohen’s d: -0.42 (-0.60 to -0.23)	r: -0.31 (-0.35 to -0.26)	r: -0.22 (-0.26 to -0.17)

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; MD: Mean difference.