Department of Health Sciences and Research, Medical University of South Carolina, Charleston, South Carolina.
Department of Health Sciences and Research, Medical University of South Carolina, Charleston, South Carolina; Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina.
Arch Phys Med Rehabil. 2020 Apr;101(4):658-666. doi: 10.1016/j.apmr.2019.11.014. Epub 2019 Dec 28.
Estimate (1) prevalence of major depressive disorder (MDD) diagnosis; (2) risk factors associated with MDD diagnosis; (3) time at which MDD is diagnosed post-spinal cord injury (SCI); and (4) interaction of inferred mobility status (IMS) in a commercially insured population over 3 years.
Retrospective longitudinal cohort design.
A commercial insurance claims database from January 1, 2010 to December 31, 2013.
Individuals with an index cervical or thoracic SCI in 2011 or 2012, without history of MDD ≤30 days pre-SCI (N=1409).
Not applicable.
Prevalence of, risk factors associated with, and time to MDD diagnosis post-SCI. A stratified survival analysis using IMS, based upon durable medical equipment (DME) claims, was also completed.
Post-SCI, 294 out of 1409 (20.87%) were diagnosed with new-onset MDD. Significant (P<.05) risk factors included: employment, length of index hospitalization, discharge from index hospitalization with healthcare services, rehabilitation services post-SCI, and 2 of 5 IMS comparisons. Median time to MDD was 86 days. Survival analysis demonstrated a significant difference between 6 of 10 IMS comparisons. Regarding new-onset or recurring MDD, 432 out of 1409 (30.66%) were diagnosed post-SCI. Significant risk factors included: female, employment, length of index hospitalization, discharge from index hospitalization with healthcare services, rehabilitation services post-SCI, MDD>30 days pre-SCI, catheter claims, and 2 of 5 IMS comparisons. Median time to MDD was 74 days. Survival analysis demonstrated a significant difference between 4 of 10 IMS comparisons.
Prevalence of MDD post-SCI is greater than the general population. Stratification by IMS illustrated that individuals with greater inferred reliance on DME are at a greater risk for MDD and have shorter time to MDD diagnosis post-SCI.
估计（1）重度抑郁症（MDD）诊断的患病率；（2）与 MDD 诊断相关的风险因素；（3）脊髓损伤（SCI）后 MDD 的诊断时间；以及（4）3 年内商业保险人群中推断的活动能力状况（IMS）的相互作用。
回顾性纵向队列设计。
2010 年 1 月 1 日至 2013 年 12 月 31 日，商业保险理赔数据库。
2011 年或 2012 年有索引颈或胸 SCI 史，无 SCI 前≤30 天 MDD 病史的个体（N=1409）。
不适用。
SCI 后 MDD 的患病率、与 MDD 诊断相关的风险因素以及 MDD 的诊断时间。还完成了基于耐用医疗设备（DME）索赔的 IMS 分层生存分析。
SCI 后，1409 例中有 294 例（20.87%）被诊断为新发 MDD。显著（P<.05）的风险因素包括：就业、索引住院时间、索引住院出院时医疗服务、SCI 后康复服务以及 5 项 IMS 比较中的 2 项。MDD 的中位时间为 86 天。生存分析表明，10 项 IMS 比较中有 6 项存在显著差异。关于新发或复发性 MDD，1409 例中有 432 例（30.66%）被诊断为 SCI 后。显著的风险因素包括：女性、就业、索引住院时间、索引住院出院时医疗服务、SCI 后康复服务、SCI 前 MDD>30 天、导管索赔以及 5 项 IMS 比较中的 2 项。MDD 的中位时间为 74 天。生存分析表明，10 项 IMS 比较中有 4 项存在显著差异。
SCI 后 MDD 的患病率高于一般人群。通过 IMS 分层表明，推断对 DME 的依赖程度较大的个体患 MDD 的风险更高，并且 SCI 后诊断 MDD 的时间更短。
