2004年至2020年中国北京慢性阻塞性肺疾病急性加重住院患者焦虑和抑郁患病率的时间趋势及其与不良结局的关联。
Temporal trends in anxiety and depression prevalence and their association with adverse outcomes in patients hospitalized for acute exacerbations of chronic obstructive pulmonary disease in Beijing, China, from 2004 to 2020.
作者信息
Feng Lin, Li Jiachen, Lv Xiaoshuang, Chu Shuilian, Li Changwei, Zhang Ruiyuan, Cao Xi, Liang Lirong
机构信息
Department of Clinical Epidemiology, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
出版信息
Front Psychiatry. 2022 Oct 31;13:996451. doi: 10.3389/fpsyt.2022.996451. eCollection 2022.
AIMS
To investigate the temporal trend in anxiety and/or depression prevalence in patients hospitalized for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in Beijing and their association with adverse outcomes.
MATERIALS AND METHODS
Hospital admission records from 2004 to 2020 with a primary discharge diagnosis of AECOPD were retrieved from Beijing Public Health Information Centre database. The anxiety and depression were identified from discharge diagnoses of each record. Joinpoint regression was used to analyze the temporal trend and calculate the annual percentage change (APC) for the prevalence of anxiety and/or depression. Generalized linear model was used to analyze the associations between anxiety and/or depression and patients' adverse outcomes.
RESULTS
A total of 382,125 records were included, most of which were male (66.0%) and aged ≥ 75 years (59.7%). Three segments in the temporal trend were observed, with a mild increase during 2004-2009 (APC: 5.9%, 95% CI: -14.9 to 31.7%), followed by a sharply increase during 2009-2012 (APC: 60.4%, 95% CI: 10.6 to 132.7%), then stabilized at about 3% during 2012-2020 (APC: 1.9%, 95% CI: -0.4 to 4.3%). On average, anxiety, and/or depression was more prevalent in females, the aged and those admitted in secondary hospitals (all < 0.001). Patients with anxiety and/or depression had lower in-hospital mortality (IHM) (OR = 0.74, 95% CI: 0.63-0.88), but longer hospital stay (OR = 1.10, 95% CI: 1.07-1.13), more medical costs (OR = 1.12, 95% CI: 1.08-1.17) and higher risks of readmission for AECOPD at 30-, 90-, 180-day, and 1-year (ORs ranged from 1.22 to 1.51).
CONCLUSION
The prevalence of anxiety and/or depression in patients hospitalized for AECOPD in Beijing stabilized at approximately 3% after 2012. Anxiety and/or depression is associated with a heavier burden on patients, health care, and medical insurance systems. Appropriate diagnosis and effective treatment of anxiety and depression is crucial for patients with AECOPD.
目的
调查北京地区因慢性阻塞性肺疾病急性加重（AECOPD）住院患者焦虑和/或抑郁患病率的时间趋势及其与不良结局的关联。
材料与方法
从北京公共卫生信息中心数据库中检索2004年至2020年以AECOPD为主要出院诊断的住院记录。从每份记录的出院诊断中识别焦虑和抑郁情况。采用Joinpoint回归分析时间趋势并计算焦虑和/或抑郁患病率的年度变化百分比（APC）。使用广义线性模型分析焦虑和/或抑郁与患者不良结局之间的关联。
结果
共纳入382,125份记录，其中大多数为男性（66.0%），年龄≥75岁（59.7%）。观察到时间趋势有三个阶段，2004 - 2009年呈轻度上升（APC：5.9%，95%CI：-14.9至31.7%），随后2009 - 2012年急剧上升（APC：60.4%，95%CI：10.6至132.7%），然后在2012 - 2020年稳定在约3%（APC：1.9%，95%CI：-0.4至4.3%）。平均而言，焦虑和/或抑郁在女性、老年人以及二级医院住院患者中更为普遍（均P<0.001）。焦虑和/或抑郁患者的住院死亡率（IHM）较低（OR = 0.74，95%CI：0.63 - 0.88），但住院时间更长（OR = 1.10，95%CI：1.07 - 1.13），医疗费用更高（OR = 1.12，95%CI：1.08 - 1.17），且在30天、90天、180天和1年时因AECOPD再次入院的风险更高（OR范围为1.22至1.51）。
结论
北京地区因AECOPD住院患者的焦虑和/或抑郁患病率在2012年后稳定在约3%。焦虑和/或抑郁与患者、医疗保健及医疗保险系统的负担加重相关。对AECOPD患者进行适当诊断和有效治疗焦虑和抑郁至关重要。
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