Department of Internal Medicine, Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, South Korea.
Department of Statistics and Actuarial Science, Soongsil University, Seoul, South Korea.
Clin Transl Gastroenterol. 2021 Apr 20;12(4):e00339. doi: 10.14309/ctg.0000000000000339.
This study investigated the risk of depression in Korean adults who underwent cholecystectomy and appeared for subsequent long-term follow-ups. A national population-based data set was used for analysis.
All patients (n = 111,934) aged 40 years and older who underwent cholecystectomy between 2010 and 2015 and a control population (n = 223,868), matched for age and sex, were identified from the database of the Korean National Health Insurance Corporation. The hazard ratio (HR) and 95% confidence interval (CI) of depression were estimated after cholecystectomy, and a Cox regression analysis was performed.
The incidence of depression in the cholecystectomy group was 27.3 per 1,000 person-years and that in the control group was 20.3 per 1,000 person-years. Patients who underwent cholecystectomy showed an increased risk of major depressive disorder (MDD) with an adjusted HR (aHR) of 1.34 (95% CI: 1.31-1.37, P < 0.001). The mean follow-up period after a 1-year lag was 3.67 ± 1.79 years. In the subgroup analysis, the risk of developing MDD after cholecystectomy was relatively high in patients aged 40-49 years (aHR 1.51, 95% CI: 1.44-1.58) and in participants without diabetes mellitus (aHR: 1.36, 95% CI: 1.33-1.39), hypertension (aHR: 1.38, 95% CI: 1.34-1.42), or dyslipidemia (aHR: 1.35, 95% CI: 1.32-1.38).
Compared with the control population, patients who underwent cholecystectomy exhibited an increased incidence of MDD. Thus, physicians should implement an enhanced program of MDD screening for at least several years after cholecystectomy.
本研究旨在探讨韩国成年人行胆囊切除术并进行后续长期随访后发生抑郁的风险。我们使用了一个全国性的人群数据进行分析。
我们从韩国国民健康保险数据库中筛选出 2010 年至 2015 年间年龄在 40 岁及以上且接受胆囊切除术的所有患者（n=111934）和年龄、性别相匹配的对照组患者（n=223868）。我们估算了胆囊切除术后抑郁的风险比（HR）和 95%置信区间（CI），并进行了 Cox 回归分析。
胆囊切除术组的抑郁发生率为 27.3/1000 人年，对照组为 20.3/1000 人年。校正后的 HR（aHR）显示，行胆囊切除术的患者发生重度抑郁症（MDD）的风险增加，为 1.34（95%CI：1.31-1.37，P<0.001）。在 1 年潜伏期后，平均随访时间为 3.67±1.79 年。在亚组分析中，40-49 岁患者（aHR 1.51，95%CI：1.44-1.58）和无糖尿病（aHR：1.36，95%CI：1.33-1.39）、高血压（aHR：1.38，95%CI：1.34-1.42）或血脂异常（aHR：1.35，95%CI：1.32-1.38）的患者，行胆囊切除术后患 MDD 的风险相对较高。
与对照组相比，行胆囊切除术的患者 MDD 的发生率增加。因此，医生应该在胆囊切除术后至少几年内实施 MDD 筛查计划。
