Wei Hui, Shi Fachao, We Qin, Wang Bin, Qiu Guoqin, Fang Caoyang
Department of Respiratory, Huzhou Central Hospital, Affiliated Central Hospital of Huzhou University, Affiliated Huzhou Hospital, Zhejiang University School of Medicine, Huzhou 313000, Zhejiang, China.
Department of Cardiology, Maanshan People's Hospital, Maanshan 243000, Anhui, China.
Can Respir J. 2025 Aug 4;2025:8833533. doi: 10.1155/carj/8833533. eCollection 2025.
At present, there is a lack of studies on depression and the likelihood for mortality among those suffering from chronic obstructive pulmonary disease (COPD). This research explores the connection between depression and the risks of overall mortality as well as cardiovascular mortality in individuals with COPD. A total of 1336 COPD patients from seven cycles of the National Health and Nutrition Examination Survey (NHANES) conducted between 2005 and 2018 were selected. We created a multivariate Cox proportional hazards model and performed a subgroup analysis to investigate the connection between depression and both overall and cardiovascular mortality. Additionally, we used restricted cubic spline (RCS) curves to examine the relationship between depression and both overall and cardiovascular mortality to better reveal the association between the two. The Kaplan-Meier technique was employed to determine the likelihood of survival. Over the course of a mean follow-up period of 91 months, 1336 COPD patients were studied, of which 340 patients experienced overall mortality, and 82 had cardiovascular-related deaths. Using RCSs, we found that depression was positively correlated with both all-cause and cardiovascular mortality in COPD patients. In the multivariable-adjusted model, individuals suffering from moderate to severe depression had a greater likelihood of overall and cardiovascular mortality compared to those without depression. The results were consistent in subgroup analyses based on age, gender, body mass index (BMI), and poverty income ratio (PIR), and there was no significant interaction between these traits and depression ( for interaction > 0.05). In COPD patients, depression is associated with higher risks of both cardiovascular and overall mortality. However, further validation of this finding is needed in large-scale prospective studies with sufficient follow-up time.
目前，关于慢性阻塞性肺疾病（COPD）患者的抑郁症与死亡可能性的研究尚缺。本研究探讨了COPD患者抑郁症与全因死亡风险及心血管死亡风险之间的联系。从2005年至2018年进行的七个周期的美国国家健康与营养检查调查（NHANES）中选取了1336例COPD患者。我们创建了多变量Cox比例风险模型并进行亚组分析，以研究抑郁症与全因死亡及心血管死亡之间的联系。此外，我们使用受限立方样条（RCS）曲线来检验抑郁症与全因死亡及心血管死亡之间的关系，以更好地揭示两者之间的关联。采用Kaplan-Meier技术确定生存可能性。在平均91个月的随访期内，对1336例COPD患者进行了研究，其中340例患者发生全因死亡，82例发生心血管相关死亡。使用RCSs，我们发现抑郁症与COPD患者的全因死亡和心血管死亡均呈正相关。在多变量调整模型中，与无抑郁症的患者相比，中重度抑郁症患者发生全因死亡和心血管死亡的可能性更大。基于年龄、性别、体重指数（BMI）和贫困收入比（PIR）的亚组分析结果一致，且这些特征与抑郁症之间无显著交互作用（交互作用>0.05）。在COPD患者中，抑郁症与心血管死亡和全因死亡的较高风险相关。然而，这一发现需要在有足够随访时间的大规模前瞻性研究中进一步验证。
