Ortiz Damaris, Perkins Anthony J, Fuchita Mikita, Gao Sujuan, Holler Emma, Meagher Ashley D, Mohanty Sanjay, French Dustin D, Lasiter Sue, Khan Babar, Boustani Malaz, Zarzaur Ben
Department of Surgery, Indiana University School of Medicine, Indianapolis, IN.
Sidney and Lois Eskenazi Hospital Smith Level One Trauma Center, Indianapolis, IN.
Ann Surg Open. 2022 Dec 7;3(4):e217. doi: 10.1097/AS9.0000000000000217. eCollection 2022 Dec.
To compare differences in baseline depression and anxiety screenings between older injured patients with pre-existing diagnoses and those without.
Little is known about the prevalence and impact of psychiatric comorbidities on early postinjury depression and anxiety in nonneurologically injured older adults.
This was a retrospective post-hoc analysis of data from the Trauma Medical Home, a multicenter randomized controlled trial (R01AG052493-01A1) that explored the effect of a collaborative care model on postinjury recovery for older adults compared to usual care.
Nearly half of the patients screened positive for at least mild depressive symptoms as measured by the Patient Health Questionnaire-9. Forty-one percent of the patients screened positive for at least mild anxiety symptoms as measured by the Generalized Anxiety Disorder Scale. Female patients with a history of concurrent anxiety and depression, greater injury severity scores, and higher Charlson scores were more likely to have mild anxiety at baseline assessment. Patients with a history of depression only, a prior history of depression and concurrent anxiety, and higher Charlson scores (greater medical comorbidity) had greater odds of at least mild depression at the time of hospital discharge after traumatic injury.
Anxiety and depression are prevalent in the older adult trauma population, and affect women disproportionately. A dual diagnosis of depression and anxiety is particularly morbid. Mental illness must be considered and addressed with the same importance as other medical diagnoses in patients with injuries.
比较有既往诊断的老年受伤患者与无既往诊断的老年受伤患者在基线抑郁和焦虑筛查方面的差异。
对于非神经损伤的老年人，精神疾病共病在伤后早期抑郁和焦虑中的患病率及影响知之甚少。
这是一项对创伤医疗之家数据的回顾性事后分析，创伤医疗之家是一项多中心随机对照试验（R01AG052493 - 01A1），该试验探索了与常规护理相比，协作护理模式对老年人伤后恢复的影响。
通过患者健康问卷 - 9测量，近一半的患者至少有轻度抑郁症状筛查呈阳性。通过广泛性焦虑障碍量表测量，41%的患者至少有轻度焦虑症状筛查呈阳性。有并发焦虑和抑郁病史、更高损伤严重程度评分以及更高查尔森评分的女性患者在基线评估时更有可能有轻度焦虑。仅有抑郁病史、既往有抑郁和并发焦虑病史以及更高查尔森评分（更高的医疗共病）的患者在创伤性损伤出院时至少有轻度抑郁的几率更高。
焦虑和抑郁在老年创伤人群中普遍存在，且对女性影响尤甚。抑郁和焦虑的双重诊断尤其具有病态性。对于受伤患者，必须将精神疾病与其他医学诊断同等重视并加以处理。
