在患有慢性病的患者中,发生抑郁症和临床结果之间的关联
Nanbo Zhu1, Suvi Virtanen1, Hong Xu2
1Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Clinical kidney journal
|November 2, 2023
概括
不接受透析的慢性病患者新发抑郁症与更糟糕的健康结果有关. 这包括住院病例的增加,CKD进展的加快,主要的不良心血管事件和较高的死亡率.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 精神病学是一个精神病学.
- 心脏病学 心脏病学
背景情况:
- 抑郁症在透析患者中很常见,但它对慢性病 (CKD) 早期阶段的影响不太清楚.
- 这项研究重点关注抑郁症与非透析依赖性CKD 3-5期患者的临床结果之间的关联.
研究的目的:
- 调查新发抑郁症和不良临床结果之间的联系,在不需要透析的CKD阶段3-5的患者中.
- 评估抑郁症对住院治疗,CKD进展,主要心血管不良事件 (MACE) 和全因死亡率的影响.
主要方法:
- 利用了来自斯德哥尔摩CREAtinine测量 (SCREAM) 项目的157,398名患有CKD 3-5期的成年人的数据.
- 采用生存分析来检查抑郁事件和结果之间的关联,以多个共同变量进行调整.
- 主要结局包括住院治疗,CKD进展,MACE和全因死亡率.
主要成果:
- 在平均5.1年的随访期间,8.1%的患者被诊断出患有抑郁症.
- 抑郁症与住院日数增加 (比率:1.77),CKD进展 (危险比率:1.38),MACE (危险比率:1.22) 和全因死亡率 (危险比率:1.41) 相关.
- 抑郁症和CKD进展之间的关联在诊断一年后变得更加明显.
结论:
- 在非透析依赖性CKD 3-5阶段的患者中,新发性抑郁症与预后不佳显著相关.
- 这些发现强调了查和管理抑郁症在这个患者群体中的重要性,以改善结果.
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