Yeh Hui-Fang, Hsu Yao-Chun, Clinciu Daniel L, Tung Heng-Hsin, Yen Yung-Chieh, Kuo Hung-Chang
Department of Nurse Practitioner, E-Da Hospital, Kaohsiung, Taiwan.
School of Nursing, National Taipei University of Nursing and Health Science, Taipei, Taiwan.
Int J Nurs Pract. 2018 Oct;24(5):e12665. doi: 10.1111/ijn.12665. Epub 2018 Jun 3.
The purpose of this study is to identify whether depression and other associated factors in stroke are related to subsequent hip fracture.
There are very few studies that focus on depression and demographic impact on subsequent hip fracture after a stroke.
This a retrospective cohort study design.
The Taiwan Longitudinal Health Insurance Database between 1997 and 2010 was used. Two stroke patient cohorts were analysed: (1) depression within 1 year after newly diagnosed strokes; (2) without depression within 1 year after newly diagnosed strokes. Demographic characteristics, comorbidities, and hip fracture were compared using the Fine and Gray regression model for subdistribution hazard ratios.
RESULTS/FINDINGS: Patients with depression showed a higher risk of hip fracture (95% CI, 0.99-1.66). Depression was associated with increased risk of hip fracture for patients below 50 years old (95% CI, 1.45-7.34). Comorbidities and gender showed no significant correlation with hip fracture risk in the depressed or nondepressed groups.
Poststroke depression was a significant contributor to hip fracture in patients who suffered strokes and had more negative impact on the younger population, regardless of the gender and presence of comorbidities.
本研究旨在确定中风后的抑郁症及其他相关因素是否与随后的髋部骨折有关。
很少有研究关注抑郁症及人口统计学因素对中风后随后髋部骨折的影响。
这是一项回顾性队列研究设计。
使用了1997年至2010年的台湾纵向健康保险数据库。分析了两个中风患者队列:(1)新诊断中风后1年内患有抑郁症的患者;(2)新诊断中风后1年内未患抑郁症的患者。使用Fine和Gray回归模型比较亚分布风险比,以比较人口统计学特征、合并症和髋部骨折情况。
结果/发现:患有抑郁症的患者髋部骨折风险更高(95%置信区间,0.99 - 1.66)。抑郁症与50岁以下患者髋部骨折风险增加相关(95%置信区间,1.45 - 7.34)。在抑郁或非抑郁组中,合并症和性别与髋部骨折风险无显著相关性。
中风后抑郁症是中风患者髋部骨折的一个重要因素,对年轻人群有更大的负面影响,无论性别和合并症情况如何。