Dunham N C, Sager M A
Department of Preventive Medicine, School of Medicine, University of Wisconsin, Madison.
Arch Fam Med. 1994 Aug;3(8):676-80; discussion 681. doi: 10.1001/archfami.3.8.676.
To assess the relationship between symptoms of depression at admission and postdischarge medical outcomes in hospitalized elderly patients.
Prospective cohort study.
Patients screened for symptoms of depression at admission using the Geriatric Depression Scale underwent assessment 1 month after discharge to determine outcomes of hospitalization.
A 370-bed, acute care, community hospital.
A sample of 197 cognitively intact, community-dwelling elderly patients, aged 70 years and older, hospitalized with medical diagnoses, with expected lengths of stay of 48 hours or more.
The Medical Outcomes Study Short-Form instrument was used to obtain data on 1-month postdischarge medical outcomes with respect to physical functioning, health status, and mental status.
On admission, a total of 23.9% had symptoms of depression (Geriatric Depression Scale score, > or = 11) that were significantly related to preadmission functional status. In multivariate analyses, depressive symptoms at admission were significantly related to 1-month medical outcomes, independent of functional status.
Findings suggest that depressive symptoms in hospitalized elderly may be reactive to physical disability and characterize a group of patients who have poorer functional status prior to admission. The effect of depressive symptoms on 1-month postdischarge medical outcomes, however, appears to be independent of and in addition to the effects of preadmission functional status.
评估老年住院患者入院时的抑郁症状与出院后医疗结局之间的关系。
前瞻性队列研究。
使用老年抑郁量表在入院时筛查抑郁症状的患者在出院1个月后接受评估，以确定住院结局。
一家拥有370张床位的急性护理社区医院。
197名认知功能完好、居住在社区的70岁及以上老年患者，因医学诊断入院，预期住院时间为48小时或更长。
使用医学结局研究简表工具获取出院1个月后关于身体功能、健康状况和精神状态的医疗结局数据。
入院时，共有23.9%的患者有抑郁症状（老年抑郁量表评分≥11），这与入院前的功能状态显著相关。在多变量分析中，入院时的抑郁症状与1个月的医疗结局显著相关，与功能状态无关。
研究结果表明，老年住院患者的抑郁症状可能是对身体残疾的反应，并且表征了一组入院前功能状态较差的患者。然而，抑郁症状对出院后1个月医疗结局的影响似乎独立于入院前功能状态的影响，并且除此之外还有影响。
