Kim Mi-Hyeong, Yoo Ju-Hwan, Cho Hyung-Jin, Ko Kyung-Jai, Jun Kang-Woong, Han Kyung-do, Hwang Jeong-Kye
Division of Vascular and Transplant Surgery, Department of Surgery, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Biomedicine and Health Science, The Catholic University of Korea, Seoul, Korea.
Ann Surg Treat Res. 2021 Nov;101(5):291-298. doi: 10.4174/astr.2021.101.5.291. Epub 2021 Oct 29.
Abdominal aortic aneurysm (AAA) is a critical disease. Most studies of AAA consider reoperation rate, complications, or mortality, but do not consider a patient's mental state. However, there is a possibility of interaction between AAA and depression in disease development and prognosis. We investigated the incidence and risk ratio of depression in patients with AAA using nationwide data.
We selected subjects from National Health Insurance System database who were diagnosed with AAA between 2009 and 2015 and survived at least 1 year after diagnosis or AAA surgery (n = 10,373). We determined the control group using propensity score matching by age and sex. The control group had about 3 times the number of subjects as the AAA cohort (n = 31,119).
The incidence of depression was 1.4 times higher in the AAA group than the control group. We further analyzed the incidence of depression in the AAA group according to treatment modalities (nonsurgical surgical or nonsurgical open surgical aneurysm repair endovascular aneurysm repair) but found no significant difference among them. The incidence of depression was significantly higher in patients aged <65 years than in patients aged ≥65 years (hazard ratio, 1.539 1.270; P < 0.001).
The incidence of depression was higher in the AAA group, with an especially high risk for depression in patients aged <65 years. The psychiatric status of patients with AAA should be carefully monitored for clinicians to intervene when appropriate.
腹主动脉瘤(AAA)是一种严重疾病。大多数关于AAA的研究关注再次手术率、并发症或死亡率,但未考虑患者的精神状态。然而,AAA与抑郁症在疾病发展和预后方面可能存在相互作用。我们使用全国性数据调查了AAA患者中抑郁症的发病率和风险比。
我们从国民健康保险系统数据库中选取了2009年至2015年间被诊断为AAA且在诊断或AAA手术后存活至少1年的受试者(n = 10373)。我们通过年龄和性别倾向得分匹配确定了对照组。对照组的受试者数量约为AAA队列的3倍(n = 31119)。
AAA组抑郁症的发病率比对照组高1.4倍。我们进一步根据治疗方式(非手术、手术或非手术、开放手术动脉瘤修复、血管内动脉瘤修复)分析了AAA组抑郁症的发病率,但未发现它们之间存在显著差异。年龄<65岁的患者抑郁症发病率显著高于年龄≥65岁的患者(风险比,1.539对1.270;P < 0.001)。
AAA组抑郁症的发病率较高,年龄<65岁的患者患抑郁症的风险尤其高。临床医生应仔细监测AAA患者的精神状态,以便在适当的时候进行干预。