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HIV感染者合并重度抑郁症患者30天再入院率危险因素的回顾性分析

A Retrospective Analysis on Risk Factors for 30-day Readmission Rates in Patients Living With HIV and Severe Major Depression Disorder.

作者信息

Kompella Sindhura, Ikekwere Joseph, Alvarez Clara, Rutkofsky Ian H

机构信息

Psychiatry, Aventura Hospital and Medical Center, Aventura, USA.

Psychiatry/Addiction, University of Illinois at Chicago, Chicago, USA.

出版信息

Cureus. 2021 Jun 24;13(6):e15894. doi: 10.7759/cureus.15894. eCollection 2021 Jun.

Abstract

Background Major depression disorder (MDD) is the most common psychiatric comorbidity in patients living with HIV (PLWHIV). The prevalence rate of MDD is higher in PLWHIV in comparison to the general population. In our study, we focus specifically on the 30-day readmission rate of PLWHIV and severe major depression. Methods The Health Care Agency (HCA) databank was used to conduct a retrospective study on PLWHIV and severe MDD. Keywords such as HIV, severe MDD, CD4, viral load were used to identify the data. 30-day readmission rate is studied in PLWHIV and severe MDD (N=143). Variables such as age, sex, gender, adherence to antiretroviral medications, cluster of differentiation 4 (CD4), and viral load were studied in this population. (DSM-5) criteria were used to diagnose severe MDD in PLWHIV. An antiretroviral therapy (ART) medication list was used to analyze adherence in this population group. Geographical locations were identified using urbanization codes. Results Logistic regression analysis for the 30-day readmission rate in PLWHIV was found to be higher in the older age group (p<0.01). Caucasian population (p<0.01) and rural areas (p<0.01), ART non-adherence (p<0.05), and severe major depression were also found to be significant in this population (p<0.01). Conclusion As more patients live longer with HIV/AIDS, it gives rise to illnesses such as anxiety, depression, and cognitive impairment. Thus, it is important to identify severe depression in PLWHIV since it can have an impact on rates of hospitalization, morbidity/mortality, and the financial burden, specifically within 30-days of discharge.

摘要

背景

重度抑郁症(MDD)是人类免疫缺陷病毒(HIV)感染者(PLWHIV)中最常见的精神科合并症。与普通人群相比,PLWHIV中MDD的患病率更高。在我们的研究中,我们特别关注PLWHIV和重度抑郁症患者的30天再入院率。方法:利用医疗保健机构(HCA)数据库对PLWHIV和重度MDD进行回顾性研究。使用诸如HIV、重度MDD、CD4、病毒载量等关键词来识别数据。对PLWHIV和重度MDD患者(N = 用抗逆转录病毒疗法(ART)药物清单分析该人群的依从性。使用城市化代码确定地理位置。结果:发现PLWHIV患者30天再入院率的逻辑回归分析在老年组中更高(p<0.01)。白种人群(p<0.01)和农村地区(p<0.01)、ART不依从(p<0.05)以及重度抑郁症在该人群中也具有显著性(p<0.01)。结论:随着越来越多的患者长期感染HIV/AIDS,引发了焦虑、抑郁和认知障碍等疾病。因此,识别PLWHIV中的重度抑郁症很重要,因为它会对住院率、发病率/死亡率以及经济负担产生影响,特别是在出院后30天内。 143)研究了年龄、性别、性别认同、抗逆转录病毒药物依从性、分化簇4(CD4)和病毒载量等变量。采用《精神疾病诊断与统计手册》第5版(DSM-5)标准诊断PLWHIV中的重度MDD。

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