Wang Tao, Ma Lina, Zhang Li, Zhang Zhongying, Zhai Wenliang, Li Yun
Department of Emergency, Capital Medical University, Xuanwu Hospital, Beijing, China.
Department of Geriatrics, Capital Medical University, Xuanwu Hospital, National Clinical Research Center for Geriatric Diseases, Beijing, China.
Alpha Psychiatry. 2024 Nov 1;25(6):721-726. doi: 10.5152/alphapsychiatry.2024.241720. eCollection 2024 Nov.
The objective is to investigate the situation and risk factors of depression in aged, hospitalized patients with chronic heart failure (CHF).
A total of 196 aged CHF patients admitted to Xuanwu Hospital from May 2022 to March 2024 were consecutively selected. Information such as demographics, comorbidities, old-age hospitalization assessment results, and admission test results was collected. Differences were found between the patients admitted with CHF and depression and those without depression. Independent predictors of depression in aged, hospitalized patients with CHF were identified using logistic regression analyses. The sensitivity and specificity of age, frailty score, and New York Heart Association (NYHA) classification to evaluate the occurrence of depression were examined by calculating the area under the curve (AUC) of the receiver operating characteristic (ROC) curve.
Increased age [OR (Odds Ratio) = 1.132, (95% CI [Confidence Interval], 1.050-1.221), = .001], higher frailty score [OR = 8.324, (95% CI, 4.233-16.368), < .001], and higher NYHA classification [OR = 3.806, (95% CI, 1.864-7.773), < .001] were independent predictors of depression in aged CHF hospitalized patients. The best indicators for the occurrence of depressive symptoms were age of 75 years, a score of 2 for frailty, and an NYHA classification of III. The AUCs for age, frailty score, and NYHA classification were 0.764, 0.876, and 0.707, respectively.
Clinical assessment of depression is necessary for aged, hospitalized CHF patients. Patients over 75 years old, with a frailty score of at least 2, and an NYHA classification of III or IV are more prone to depression, which requires attention.
探讨老年住院慢性心力衰竭（CHF）患者抑郁状况及危险因素。
连续选取2022年5月至2024年3月在宣武医院住院的196例老年CHF患者。收集人口统计学、合并症、老年住院评估结果及入院检查结果等信息。比较CHF合并抑郁患者与未合并抑郁患者的差异。采用逻辑回归分析确定老年住院CHF患者抑郁的独立预测因素。通过计算受试者工作特征（ROC）曲线下面积（AUC），检验年龄、衰弱评分和纽约心脏协会（NYHA）分级对评估抑郁发生的敏感性和特异性。
年龄增加[比值比（OR）=1.132，95%置信区间（CI）为1.050 - 1.221，P = 0.001]、衰弱评分较高[OR = 8.324，95%CI为4.233 - 16.368，P < 0.001]及NYHA分级较高[OR = 3.806，95%CI为1.864 - 7.773，P < 0.001]是老年CHF住院患者抑郁的独立预测因素。抑郁症状发生的最佳指标为年龄75岁、衰弱评分为2分及NYHA分级为Ⅲ级。年龄、衰弱评分和NYHA分级的AUC分别为0.764、0.876和0.707。
老年住院CHF患者有必要进行抑郁的临床评估。75岁以上、衰弱评分至少为2分且NYHA分级为Ⅲ或Ⅳ级的患者更容易发生抑郁，需予以关注。
