静脉血栓栓塞与抑郁风险：一项基于人群的队列研究。

Venous thromboembolism and risk of depression: a population-based cohort study.

作者信息

Jørgensen Helle, Horváth-Puhó Erzsébet, Laugesen Kristina, Brækkan Sigrid K, Hansen John-Bjarne, Sørensen Henrik Toft

机构信息

Thrombosis Research Center, Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway; Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark; Division of Internal Medicine, University Hospital of North Norway, Tromsø, Norway.

Department of Clinical Epidemiology, Aarhus University Hospital and Aarhus University, Aarhus, Denmark.

出版信息

J Thromb Haemost. 2023 Apr;21(4):953-962. doi: 10.1016/j.jtha.2022.12.006. Epub 2022 Dec 22.

DOI:10.1016/j.jtha.2022.12.006

PMID:36696217

Abstract

BACKGROUND

The psychologic consequences of acute venous thromboembolism (VTE) have not been investigated in depth.

OBJECTIVES

We aimed to examine the association between VTE and the risk of subsequent depression.

METHODS

Using Danish nationwide registries, we established a population-based cohort of 64 596 individuals with incident VTE during 1996 to 2016 and a comparison cohort (n = 322 999) selected randomly from the general population and individually matched by birth year, sex, and calendar year of VTE. The participants were followed up for 3 years, and depression was defined as any hospital diagnosis of depression or ≥1 prescription for antidepressants. Incidence rates were computed as the number of events per 1000 person-years, and hazard ratios with 95% CIs were computed as estimates of the risk conferred by VTE using the comparison cohort as reference. We estimated absolute risks using cumulative incidence functions, treating death as a competing event.

RESULTS

Depression was observed in 6225 individuals after VTE and 16 363 members of the comparison cohort (incidence rates of 44.4 and 19.4 per 1000 person-years, respectively). The absolute risk of depression was 10.3% (95% CI, 10.1%-10.6%) in the VTE cohort and 5.6% (95% CI, 5.5%-5.6%) in the comparison cohort, corresponding to 4.7 excess cases of depression per 100 individuals with VTE. VTE was associated with a 2.35-fold (95% CI, 2.28-2.43) increased risk of depression compared with that in the comparison cohort. The association was attenuated after adjustments for socioeconomic status and comorbidities (hazard ratio, 1.91; 95% CI, 1.85-1.97).

CONCLUSION

VTE was associated with an increased risk of depression after adjustment for comorbidities.

摘要

背景

急性静脉血栓栓塞症（VTE）的心理后果尚未得到深入研究。

目的

我们旨在研究VTE与后续发生抑郁症风险之间的关联。

方法

利用丹麦全国性登记处的数据，我们建立了一个基于人群的队列，其中包括1996年至2016年间发生VTE的64596名个体，以及一个从普通人群中随机选取的对照队列（n = 322999），并按出生年份、性别和VTE发生的日历年进行个体匹配。对参与者进行了3年的随访，抑郁症定义为任何医院诊断的抑郁症或≥1次抗抑郁药处方。发病率计算为每1000人年的事件数，以对照队列为参照，计算VTE所致风险估计值的风险比及95%置信区间。我们使用累积发病率函数估计绝对风险，将死亡视为竞争事件。

结果

VTE后6225名个体和对照队列中的16363名成员出现抑郁症（发病率分别为每1000人年44.4例和19.4例）。VTE队列中抑郁症的绝对风险为10.3%（95%置信区间，10.1%-10.6%），对照队列为5.6%（95%置信区间，5.5%-5.6%），相当于每100名VTE患者中有4.7例额外的抑郁症病例。与对照队列相比，VTE与抑郁症风险增加2.35倍（95%置信区间，2.28-2.43）相关。在对社会经济状况和合并症进行调整后，这种关联减弱（风险比，1.91；95%置信区间，1.85-1.97）。