Research Unit for General Practice.
Department of Public Health, Aarhus University.
Med Care. 2021 Oct 1;59(10):872-880. doi: 10.1097/MLR.0000000000001626.
Depression is highly prevalent among hospitalized patients with pneumonia. At discharge, these patients transfer to a less care-intensive home-based setting. Nevertheless, little is known on the prognosis in the postdischarge period.
The objective of this study was to investigate the influence of depression on 30-day mortality and readmission in persons discharged after a pneumonia admission.
This was a population-based cohort study using the Danish registries.
All persons aged 50+ years with a pneumonia admission in 2000-2016 in Denmark.
Mortality rate ratios for 30-day mortality and incidence rate ratios for 30-day readmission in pneumonia patients with versus without depression.
We identified 379,265 pneumonia admissions, hereof 83,257 (22.0%) with depression. The overall adjusted mortality rate ratio was 1.29 (95% confidence interval: 1.25-1.33), and the overall adjusted incidence rate ratio was 1.07 (95% confidence interval: 1.05-1.08). The mortality risk was higher for all ages and throughout the 30-day period in persons with versus without depression. This risk was modified by sociodemographic and socioeconomic characteristics (excluding sex and education), admission-related factors, comorbidities, and use of benzodiazepines, opioids, or antipsychotics. The readmission risk was higher until age 90 and tended to be higher throughout the 30-day period. This risk was modified by age, cohabitation, residency, admission-related factors, comorbidities, and use of opioids or antipsychotics. For both outcomes, the relative effect of depression was highest among the youngest, among those with a short hospital stay and among those with few comorbidities.
Depression is an independent risk factor for 30-day mortality and readmission in persons who transfer from hospital care to home-based care.
肺炎住院患者中抑郁症的发病率很高。出院后，这些患者转移到医疗护理强度较低的居家环境中。然而，对于出院后患者的预后情况知之甚少。
本研究旨在探讨抑郁对肺炎出院患者 30 天死亡率和再入院率的影响。
这是一项基于人群的队列研究，使用丹麦的登记数据。
2000 年至 2016 年期间在丹麦因肺炎住院的所有 50 岁以上患者。
肺炎患者中存在和不存在抑郁时，30 天死亡率的死亡率比值比和 30 天再入院率的发病率比值比。
我们共确定了 379265 例肺炎住院患者，其中 83257 例（22.0%）存在抑郁。总体校正后的死亡率比值比为 1.29（95%置信区间：1.25-1.33），总体校正后的发病率比值比为 1.07（95%置信区间：1.05-1.08）。与无抑郁的患者相比，所有年龄段的患者在有抑郁的情况下，30 天内的死亡风险更高。这种风险受到社会人口统计学和社会经济特征（性别和教育除外）、入院相关因素、合并症以及苯二氮䓬类、阿片类或抗精神病药物使用的影响。再入院风险直到 90 岁时更高，并且在 30 天内呈上升趋势。这种风险受到年龄、同居、居住地、入院相关因素、合并症以及阿片类或抗精神病药物使用的影响。对于这两个结局，抑郁的相对影响在最年轻的患者、住院时间短的患者和合并症少的患者中最高。
抑郁是从医院护理转移到家庭护理的患者 30 天死亡率和再入院率的独立危险因素。
