Suárez-Linares Mónica, Cobo-Gómez Jesús Vicente, Suárez-García Francisco Manuel, García-Carreño Elena, Alvarez-Alvarez Antonio
Servicio de Geriatría, Hospital Monte Naranco, Oviedo, España.
Rev Esp Geriatr Gerontol. 2009 Nov-Dec;44(6):305-10. doi: 10.1016/j.regg.2009.07.002. Epub 2009 Oct 27.
Depression is especially frequent in the elderly. In addition to impairing quality of life, this disorder can affect the outcome of medical diseases. The objective is to analyze whether depressive disorders in elderly individuals attending an emergency room for medical complaints constitute a risk factor for admission.
All patients aged more than 74 years old attending the Emergency Department of the Hospital Universitario Central de Asturias who required comprehensive geriatric assessment from 2004 to 2005 were included in this study. Sociodemographic variables and data on functional, cognitive and emotional status before attendance at the emergency department were collected. A logistic regression analysis was performed to determine whether there was an independent association between depression and admission to the Geriatric Service.
A total of 1016 patients (62.32% women) were evaluated. The mean age was 87.4 years. The Barthel index before admission to the emergency department was 71.8 (95% confidence interval [CI]: Depression was diagnosed in 17.4% of the patients (75.7% women). Of the whole sample, 721 patients (71.0%) were admitted to a geriatric service, while 79.7% of patients with depression were admitted (p=0.002). After multivariate regression analysis adjusted by age, sex, marital status, institutionalization, living arrangements, Barthel index and cognitive status before admission, depression was independently associated with a greater risk for admission to a geriatric service (odds ratio: 1.83, 95% CI: 1.20-2.78).
Depression and mood disorders constitute an independent risk factor for admission to a geriatric service in patients aged more than 74 years assessed by comprehensive geriatric methodology in an emergency department.
抑郁症在老年人中尤为常见。除了损害生活质量外，这种疾病还会影响内科疾病的治疗结果。目的是分析因内科疾病到急诊室就诊的老年患者的抑郁症是否构成入院风险因素。
本研究纳入了2004年至2005年在阿斯图里亚斯中央大学医院急诊科就诊且需要进行全面老年评估的所有74岁以上患者。收集了社会人口统计学变量以及就诊前的功能、认知和情绪状态数据。进行逻辑回归分析以确定抑郁症与老年科入院之间是否存在独立关联。
共评估了1016例患者（62.32%为女性）。平均年龄为87.4岁。入院前急诊室的巴氏指数为71.8（95%置信区间[CI]：17.4%的患者被诊断为抑郁症（75.7%为女性）。在整个样本中，721例患者（71.0%）被收入老年科，而抑郁症患者中有79.7%被收入（p = 0.002）。在对年龄、性别、婚姻状况、机构化、居住安排、巴氏指数和入院前认知状态进行多因素回归分析调整后，抑郁症与老年科入院风险增加独立相关（优势比：1.83，95% CI：1.20 - 2.78）。
在急诊科采用全面老年评估方法评估的74岁以上患者中，抑郁症和情绪障碍构成了入住老年科的独立风险因素。
