Ren Defang, Wang Xingyue, Shen Hongping, Li Tao, Sun Xingyu
Phase I Clinical Research Center, The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, 646000, Sichuan, China.
Department of Gastroenterology, Rheumatology, and Immunology, The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, 646000, Sichuan, China.
BMC Psychiatry. 2025 Jun 6;25(1):585. doi: 10.1186/s12888-025-07038-1.
Anxiety and depression are prevalent among elderly inpatients and may significantly influence clinical outcomes, particularly in patients with chronic diseases. However, limited research has explored these psychological conditions in elderly patients with digestive system diseases in the Southwest China region.
This study aimed to evaluate the associations between depression symptoms and clinical outcomes in elderly inpatients with digestive system diseases in Southwest China. Anxiety symptoms were examined as an associated variable and further analyzed in exploratory subgroup assessments.
A retrospective cohort study was conducted using data from 1,290 elderly inpatients aged 60 years or older hospitalized with a primary diagnosis of digestive system disease between January 2018 and December 2022 at a tertiary care hospital in Southwest China. Anxiety and depression symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS), with a score ≥ 8 indicating clinically relevant symptoms. Clinical outcomes included prolonged hospital stay (≥ 14 days), hospitalization costs, complications during hospitalization, 30-day readmission, and in-hospital mortality. Multivariable logistic regression models were used to examine the associations, and subgroup analyses stratified by gender and age were performed.
Anxiety symptoms were observed in 33.2% of patients, while 37.4% exhibited depression symptoms. Depression was significantly associated with longer hospital stays (14.2 ± 6.3 vs. 11.3 ± 5.2 days, P < 0.001), higher hospitalization costs (¥12,300 vs. ¥10,800, P < 0.001), and increased complication rates, including infections (29.5% vs. 20.8%, P < 0.001) and gastrointestinal bleeding (19.1% vs. 11.6%, P < 0.001). Subgroup analyses revealed that anxiety symptoms were strongly associated with prolonged hospital stays, particularly among female patients aged ≥ 70 years (adjusted OR: 2.35, 95% CI: 1.68-3.30, P < 0.001). Multivariable analysis identified poor sleep quality, cognitive impairment, and digestive system tumors as variables independently associated with anxiety symptoms.
Anxiety and depression symptoms are prevalent among elderly inpatients with digestive system diseases in Southwest China and are associated with adverse clinical outcomes, including prolonged hospital stay, increased healthcare costs, and higher complication rates. Female patients and those aged ≥ 70 years are particularly vulnerable. Early psychological assessment and targeted interventions may improve clinical outcomes in this population.
焦虑和抑郁在老年住院患者中普遍存在，可能会显著影响临床结局，尤其是在患有慢性疾病的患者中。然而，在中国西南地区，针对老年消化系统疾病患者的这些心理状况的研究有限。
本研究旨在评估中国西南地区老年消化系统疾病住院患者抑郁症状与临床结局之间的关联。将焦虑症状作为一个相关变量进行检查，并在探索性亚组评估中进一步分析。
采用回顾性队列研究，使用2018年1月至2022年12月期间在中国西南地区一家三级医院住院的1290例60岁及以上以消化系统疾病为主要诊断的老年住院患者的数据。使用医院焦虑抑郁量表（HADS）评估焦虑和抑郁症状，得分≥8分表示具有临床相关症状。临床结局包括住院时间延长（≥14天）、住院费用、住院期间并发症、30天再入院率和院内死亡率。使用多变量逻辑回归模型检查关联，并按性别和年龄进行亚组分析。
33.2%的患者出现焦虑症状，37.4%的患者出现抑郁症状。抑郁与更长的住院时间（14.2±6.3天对11.3±5.2天，P<0.001）、更高的住院费用（12300元对10800元，P<0.001）以及更高的并发症发生率显著相关，包括感染（29.5%对20.8%，P<0.001）和胃肠道出血（19.1%对11.6%，P<0.001）。亚组分析显示，焦虑症状与住院时间延长密切相关，尤其是在年龄≥70岁的女性患者中（调整后的OR：2.35，95%CI：1.68-3.30，P<0.001）。多变量分析确定睡眠质量差、认知障碍和消化系统肿瘤是与焦虑症状独立相关的变量。
焦虑和抑郁症状在中国西南地区老年消化系统疾病住院患者中普遍存在，并且与不良临床结局相关，包括住院时间延长、医疗费用增加和并发症发生率更高。女性患者和年龄≥70岁的患者尤其脆弱。早期心理评估和针对性干预可能会改善该人群的临床结局。
