Lesman-Leegte Ivonne, Jaarsma Tiny, Sanderman Robbert, Linssen Gerard, van Veldhuisen Dirk J
Department of Cardiology, University Medical Center Groningen, University of Groningen, PO Box 30.001, 9700 RB Groningen, The Netherlands.
Eur J Heart Fail. 2006 Oct;8(6):634-40. doi: 10.1016/j.ejheart.2005.11.010. Epub 2006 Feb 28.
There are limited data on the prevalence of depressive symptoms in hospitalised elderly HF patients and demographic and clinical characteristics associated with depressive symptoms are not known.
A sample of 572 HF patients (61% male; age 71+/-12 years; LVEF 34%+/-15) was recruited from 17 Dutch hospitals during HF admission. Depressive symptoms were assessed by the CES-D. Demographic, clinical variables and HF symptoms were collected from patient chart and interview.
Forty one percent of the patients had symptoms of depression with women significantly more often reporting depressive symptoms than men 48% vs. 36% (chi(2)=8.1, p<0.005). HF patients with depressive symptoms reported more clinical HF symptoms than patients without depressive symptoms. Even after deleting HF related symptoms (sleep disturbances and loss of appetite) from the CES-D scale, 36% of patients were still found to have symptoms of depression. Multivariable logistic regression analyses revealed that depressive symptoms were associated with female gender (odds 1.68, 95% CI 1.14-2.48), COPD (odds 2.11, 95% CI 1.35-3.30), sleep disturbance (odds 3.45, 95% CI 2.03-5.85) and loss of appetite (odds 2.61, 95% CI 1.58-4.33).
Depressive symptoms are prominent in elderly hospitalised HF patients especially in women. Depressive symptoms are associated with more pronounced symptomatology, despite the fact that other indices of severity of left ventricular dysfunction are similar.
关于住院老年心力衰竭(HF)患者抑郁症状的患病率数据有限,且与抑郁症状相关的人口统计学和临床特征尚不清楚。
在17家荷兰医院中,选取了572例HF患者(男性占61%;年龄71±12岁;左心室射血分数[LVEF]34%±15),这些患者均在因HF入院期间被纳入研究。采用流调中心用抑郁量表(CES-D)评估抑郁症状。从患者病历和访谈中收集人口统计学、临床变量及HF症状等信息。
41%的患者有抑郁症状,女性报告抑郁症状的比例显著高于男性,分别为(48%对36%,χ² = 8.1,p < 0.005)。有抑郁症状的HF患者比无抑郁症状的患者报告更多的临床HF症状。即使从CES-D量表中剔除与HF相关的症状(睡眠障碍和食欲减退)后,仍有36%的患者被发现有抑郁症状。多变量逻辑回归分析显示,抑郁症状与女性性别(比值比1.68,95%置信区间1.14 - 2.48)、慢性阻塞性肺疾病(COPD,比值比2.11,95%置信区间1.35 - 3.3)、睡眠障碍(比值比3.45,95%置信区间2.03 - 5.85)和食欲减退(比值比2.61,95%置信区间1.58 - 4.33)相关。
抑郁症状在住院老年HF患者中很突出,尤其是女性。尽管左心室功能障碍的其他严重程度指标相似,但抑郁症状与更明显的症状表现相关。