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术后胶质瘤患者焦虑和抑郁的危险因素、预后效力及纵向变化

Risk factors, prognostic potency, and longitudinal variation of anxiety and depression in postoperative glioma patients.

作者信息

Wu Xiaohua, Wang Dongdong, Wang Dan

机构信息

Department of Neurosurgery IV, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.

Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.

出版信息

Front Surg. 2023 Jan 16;9:1069709. doi: 10.3389/fsurg.2022.1069709. eCollection 2022.

Abstract

OBJECTIVE

Anxiety and depression are common mental disorders in glioma patients. This study aimed to evaluate the risk factors, prognostic role, and longitudinal changes in anxiety and depression in postoperative glioma patients.

METHODS

Anxiety and depression were assessed by Hospital Anxiety and Depression Scale at baseline, month (M) 6, M12, M24 and M36 in 270 glioma patients after surgical resection. Furthermore, comprehensive clinic characteristics and treatment-related information were collected.

RESULTS

Gender (female vs. male) (= 0.014, odds ratio (OR) = 1.974), marital status (single/divorced/widowed vs. married) (= 0.019, OR = 2.172), Karnofsky performance status (KPS) score (≤70 vs. > 70) (= 0.002, OR = 2.556), World Health Organization (WHO) classification (high-grade glioma (HGG) vs. low-grade glioma (LGG)) (= 0.005, OR = 2.155), and postoperative complications (yes vs. not) (= 0.001, OR = 2.525) were independently related to anxiety occurrence. Marital status (single/divorced/widowed vs. married) (= 0.034, OR = 2.026), KPS score (≤70 vs. > 70) (< 0.001, OR = 3.880), WHO classification (HGG vs. LGG) (= 0.032, OR = 1.810), and postoperative complications (yes vs. not) (= 0.001, OR = 2.602) were independently related to depression occurrence. Besides, anxiety (= 0.038) and depression (= 0.013) were linked with shorter overall survival (OS), and depression was an independent risk factor for worse OS (= 0.040, hazard ratio = 1.596). More importantly, anxiety and depression remained at a high prevalence during a 3-year follow-up.

CONCLUSION

Gender, marital status, KPS score, WHO classification, and postoperative complications are risk factors for anxiety and depression; moreover, anxiety and depression are at high prevalence continuously and correlated with worse survival in postoperative glioma patients.

摘要

目的

焦虑和抑郁是胶质瘤患者常见的精神障碍。本研究旨在评估术后胶质瘤患者焦虑和抑郁的危险因素、预后作用及纵向变化。

方法

采用医院焦虑抑郁量表对270例接受手术切除的胶质瘤患者在基线、术后6个月、12个月、24个月和36个月时的焦虑和抑郁情况进行评估。此外,收集了综合临床特征和治疗相关信息。

结果

性别(女性与男性)(=0.014,比值比(OR)=1.974)、婚姻状况(单身/离异/丧偶与已婚)(=0.019,OR=2.172)、卡氏功能状态(KPS)评分(≤70与>70)(=0.002,OR=2.556)、世界卫生组织(WHO)分类(高级别胶质瘤(HGG)与低级别胶质瘤(LGG))(=0.005,OR=2.155)以及术后并发症(有与无)(=0.001,OR=2.525)与焦虑的发生独立相关。婚姻状况(单身/离异/丧偶与已婚)(=0.034,OR=2.026)、KPS评分(≤70与>70)(<0.001,OR=3.880)、WHO分类(HGG与LGG)(=0.032,OR=1.810)以及术后并发症(有与无)(=0.001,OR=2.602)与抑郁的发生独立相关。此外,焦虑(=0.038)和抑郁(=0.013)与总生存期(OS)缩短相关,且抑郁是OS较差的独立危险因素(=0.040,风险比=1.596)。更重要的是,在3年随访期间,焦虑和抑郁的患病率一直居高不下。

结论

性别、婚姻状况、KPS评分、WHO分类和术后并发症是焦虑和抑郁的危险因素;此外,焦虑和抑郁在术后胶质瘤患者中持续高发,且与较差的生存率相关。

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