虚弱调整后抑郁的躯体症状丧失与死亡率的关联:来自健康血液透析队列的分析

IF 1.7 Q3 UROLOGY & NEPHROLOGY
Benjamin M Anderson, Muhammad Qasim, Gonzalo Correa, Felicity Evison, Suzy Gallier, Charles J Ferro, Thomas A Jackson, Adnan Sharif
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引用次数: 0

摘要

抑郁症的躯体症状成分与住院率和死亡率增加以及健康相关生活质量(HRQOL)下降有关。然而,抑郁症状亚群与虚弱和预后的关系尚不清楚。本研究旨在(1)探讨临床虚弱量表(CFS)与血液透析患者抑郁成分之间的关系;(2)CFS与血液透析患者死亡率、住院率和HRQOL的关系。方法:我们对流行的血液透析受者进行了一项前瞻性队列研究,其深层生物临床表型包括CFS和PHQ-9躯体(疲劳、食欲差和睡眠差)和认知成分评分。EuroQol EQ-5D综合指数在基线时评估HRQOL。与英国国家管理数据集的电子链接确保了住院和死亡事件的可靠随访数据。发现。体细胞(β = 0.067;95% C.I. 0.029 ~ 0.104;P < 0.001)和认知能力(β = 0.062;95% C.I. 0.034 ~ 0.089;pβ = -0.062;95% C.I. -0.104 ~ -0.021;pβ = 0.052;95% C.I. -0.081 ~ -0.024;P < 0.001)评分与较低的HRQOL相关。在多变量模型中加入CFS后,躯体评分丧失死亡率(HR1.06;95% ci = 0.977 ~ 1.14;P = 0.173)。认知症状与死亡率无关。在多变量分析中,两项成分得分均与住院率无关。结论:血液透析受者的躯体和认知抑郁症状与虚弱和较差的HRQOL相关,但在调整虚弱因素后与死亡率或住院率无关。抑郁躯体评分的风险特征可能与虚弱症状重叠有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Somatic Symptoms of Depression Lose Association with Mortality upon Adjustment for Frailty: Analysis from the Fitness Haemodialysis Cohort.

Somatic Symptoms of Depression Lose Association with Mortality upon Adjustment for Frailty: Analysis from the Fitness Haemodialysis Cohort.

Somatic Symptoms of Depression Lose Association with Mortality upon Adjustment for Frailty: Analysis from the Fitness Haemodialysis Cohort.

Somatic Symptoms of Depression Lose Association with Mortality upon Adjustment for Frailty: Analysis from the Fitness Haemodialysis Cohort.

Introduction: The somatic symptom component of depression is associated with increased hospitalisation and mortality and poorer health-related quality of life (HRQOL). However, the relationship of subsets of depression symptoms with frailty and outcomes is not known. This study aimed to (1) explore the relationship between the Clinical Frailty Scale (CFS) and components of depression and (2) their association with mortality, hospitalisation, and HRQOL in haemodialysis recipients.

Methods: We conducted a prospective cohort study of prevalent haemodialysis recipients, with deep bio-clinical phenotyping including CFS and PHQ-9 somatic (fatigue, poor appetite, and poor sleep) and cognitive component scores. EuroQol EQ-5D summary index assessed HRQOL at the baseline. Electronic linkage to English national administration datasets ensured robust follow-up data for hospitalisation and mortality events. Findings. Somatic (β = 0.067; 95% C.I. 0.029 to 0.104; P < 0.001) and cognitive (β = 0.062; 95% C.I. 0.034 to 0.089; P<0.001) components were associated with increased CFS scores. Both somatic (β = -0.062; 95% C.I. -0.104 to -0.021; P<0.001) and cognitive (β = 0.052; 95% C.I. -0.081 to -0.024; P < 0.001) scores were associated with lower HRQOL. Somatic scores lost mortality association on addition of CFS to the multivariable model (HR1.06; 95% C.I. 0.977 to 1.14; P=0.173). Cognitive symptoms were not associated with mortality. Neither the component score was associated with hospitalisation on multivariable analyses.

Conclusions: Both somatic and cognitive depression symptoms are associated with frailty and poorer HRQOL in haemodialysis recipients but were not associated with mortality or hospitalisation when adjusted for frailty. The risk profile of depression somatic scores may be related to overlap with symptoms of frailty.

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来源期刊
International Journal of Nephrology
International Journal of Nephrology UROLOGY & NEPHROLOGY-
CiteScore
3.40
自引率
4.80%
发文量
44
审稿时长
17 weeks
期刊介绍: International Journal of Nephrology is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies focusing on the prevention, diagnosis, and management of kidney diseases and associated disorders. The journal welcomes submissions related to cell biology, developmental biology, genetics, immunology, pathology, pathophysiology of renal disease and progression, clinical nephrology, dialysis, and transplantation.
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