Effects of Ward Noise on Sleep Quality and Emotional State in Older Patients with Proximal Humerus Fractures: A Retrospective Study.

OBJECTIVE: This retrospective study evaluates the effects of ward noise levels on sleep quality and emotional state in older patients with proximal humerus fractures. METHODS: A total of 156 older patients (aged ≥65 years) admitted with proximal humerus fractures between January 2022 and December 2024 were enrolled and stratified into two groups based on average ward noise exposure: a high noise exposure (HNE) group (n = 78, average noise >55 dB) and low noise exposure (LNE) group (n = 78, average noise ≤55 dB). Primary outcomes were sleep quality [Pittsburgh Sleep Quality Index (PSQI)], emotional state [Hospital Anxiety and Depression Scale (HADS)], and physiological stress (salivary cortisol levels). Additional assessments included pain intensity [Visual Analog Scale (VAS)], functional outcomes [Disabilities of the Arm, Shoulder, and Hand questionnaire (DASH)], and length of hospital stay. Data were collected at baseline and discharge. RESULTS: At discharge, the HNE group exhibited significantly higher PSQI scores (9.24 ± 2.15 vs. 6.87 ± 1.93, P < 0.001) and HADS scores for anxiety (8.42 ± 2.38 vs. 5.96 ± 2.12, P < 0.001) and depression (7.85 ± 2.26 vs. 5.43 ± 1.89, P < 0.001) compared with the LNE group. Salivary cortisol levels were elevated in the HNE group (0.67 ± 0.14 vs. 0.45 ± 0.11 µg/dL, P < 0.001). The HNE group had higher VAS pain scores (6.78 ± 1.45 vs. 4.92 ± 1.32, P < 0.001), worse functional outcomes (DASH: 58.92 ± 12.34 vs. 48.76 ± 11.28, P < 0.001), and longer hospital stays (8.45 ± 2.67 vs. 6.83 ± 2.14 days, P < 0.001). CONCLUSION: Elevated noise levels in hospital wards correlate with impaired sleep quality, worsened emotional state, heightened physiological stress, and prolonged recovery in older patients with proximal humerus fractures, highlighting the importance of noise-reduction interventions in orthopedic wards.