Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Critical Illness, Brain Dysfunction, and Survivorship Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Int Psychogeriatr. 2023 Aug;35(8):433-438. doi: 10.1017/S1041610221002556. Epub 2021 Nov 12.
We examined whether preadmission history of depression is associated with less delirium/coma-free (DCF) days, worse 1-year depression severity and cognitive impairment.
A health proxy reported history of depression. Separate models examined the effect of preadmission history of depression on: (a) intensive care unit (ICU) course, measured as DCF days; (b) depression symptom severity at 3 and 12 months, measured by the Beck Depression Inventory-II (BDI-II); and (c) cognitive performance at 3 and 12 months, measured by the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) global score.
Patients admitted to the medical/surgical ICU services were eligible.
Of 821 subjects eligible at enrollment, 261 (33%) had preadmission history of depression. After adjusting for covariates, preadmission history of depression was not associated with less DCF days (OR 0.78, 95% CI, 0.59-1.03 = 0.077). A prior history of depression was associated with higher BDI-II scores at 3 and 12 months (3 months OR 2.15, 95% CI, 1.42-3.24 = <0.001; 12 months OR 1.89, 95% CI, 1.24-2.87 = 0.003). We did not observe an association between preadmission history of depression and cognitive performance at either 3 or 12 months (3 months beta coefficient -0.04, 95% CI, -2.70-2.62 = 0.97; 12 months 1.5, 95% CI, -1.26-4.26 = 0.28).
Patients with a depression history prior to ICU stay exhibit a greater severity of depressive symptoms in the year after hospitalization.
我们研究了 ICU 住院前的抑郁史是否与更少的谵妄/昏迷无天数（DCF）、更严重的 1 年抑郁严重程度和认知障碍有关。
健康代理人报告了抑郁史。分别的模型检查了 ICU 住院前的抑郁史对以下方面的影响：（a）通过 DCF 天数测量的 ICU 病程；（b）3 个月和 12 个月时的抑郁症状严重程度，用 Beck 抑郁量表-II（BDI-II）测量；（c）3 个月和 12 个月时的认知表现，用重复认知评估系统（RBANS）的全球评分测量。
符合条件的是入住内科/外科 ICU 服务的患者。
在符合条件的 821 名患者中，有 261 名（33%）有 ICU 住院前的抑郁史。在调整了协变量后，ICU 住院前的抑郁史与 DCF 天数较少无关（OR 0.78，95% CI，0.59-1.03 = 0.077）。抑郁史与 3 个月和 12 个月时更高的 BDI-II 评分有关（3 个月 OR 2.15，95% CI，1.42-3.24 = <0.001；12 个月 OR 1.89，95% CI，1.24-2.87 = 0.003）。我们没有观察到 ICU 住院前的抑郁史与 3 个月或 12 个月时的认知表现之间的关联（3 个月的β系数-0.04，95% CI，-2.70-2.62 = 0.97；12 个月 1.5，95% CI，-1.26-4.26 = 0.28）。
在 ICU 住院前有抑郁史的患者在住院后一年表现出更严重的抑郁症状。
