Division of Nephrology, University Hospital Zurich, Rämistrasse 100, Zurich CH-8001, Switzerland.
Institute for Complementary and Integrative Medicine, University Hospital Zurich and University Zurich, Zurich, Switzerland.
J Affect Disord. 2019 Mar 15;247:175-182. doi: 10.1016/j.jad.2019.01.013. Epub 2019 Jan 15.
Depression is common among senior adults, yet understudied among trauma patients. The purpose of this study was to assess the prevalence of depressive symptoms among seniors hospitalized in acute trauma care, to compare patients with depressive symptoms vs. those without, and to evaluate whether depression symptoms affects discharge destination.
This cross-sectional and prospective analysis was conducted among community-dwelling patients ≥70 years old, hospitalized at the Senior Trauma Center of the University Hospital Zurich, Switzerland. We used the Geriatric Depression Scale (GDS-15) to assess presence of depressive symptoms. Using a cutoff value of 5 points, we compared age- and gender-adjusted characteristics of patients with and without depressive symptoms. Multinomial logistic regression models were used to estimate the odds of returning home vs. not adjusting for age, gender, nutritional status, cognitive function and others.
Of the 273 seniors enrolled, 104 (38.1%) were men and the mean age was 79.4 (SD = 6.5) years. We identified 52 (19.0%) patients with depressive symptoms. These patients were more likely to be older (p = 0.04), at risk for malnutrition (p<0.0001), at least pre-frail (p = 0.005), and have decreased cognitive function (p = 0.001). They were also more than twice as likely to be discharged to acute geriatric care compared to home (OR = 2.28 (CI = 1.12-4.68)).
Depressive symptoms were assessed during acute care without data before hospitalization.
Senior trauma patients with depressive symptoms during acute care were more likely to be at higher risk of malnutrition, have cognitive decline and are more likely to receive additional geriatric care.
抑郁症在老年人中很常见，但在创伤患者中研究较少。本研究旨在评估在急性创伤护理中住院的老年人中抑郁症状的患病率，比较有抑郁症状的患者和没有抑郁症状的患者，并评估抑郁症状是否影响出院去向。
这是一项横断面和前瞻性分析，在瑞士苏黎世大学医院老年创伤中心的社区居住患者中进行，年龄≥70 岁。我们使用老年抑郁量表（GDS-15）评估是否存在抑郁症状。使用 5 分的截断值，我们比较了有和没有抑郁症状的患者的年龄和性别调整特征。使用多项逻辑回归模型估计调整年龄、性别、营养状况、认知功能等因素后回家的几率。
在纳入的 273 名老年人中，104 名（38.1%）为男性，平均年龄为 79.4（SD=6.5）岁。我们发现 52 名（19.0%）患者有抑郁症状。这些患者更有可能年龄较大（p=0.04），有营养不良风险（p<0.0001），至少是虚弱前期（p=0.005），认知功能下降（p=0.001）。与回家相比，他们更有可能被送往急性老年护理（OR=2.28（CI=1.12-4.68））。
在急性护理期间评估抑郁症状，没有住院前的数据。
在急性护理期间有抑郁症状的老年创伤患者更有可能面临更高的营养不良风险、认知能力下降的风险，并且更有可能接受额外的老年护理。
