Effect of anxiety and depression on prognosis of elderly patients with heart failure
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摘要: 目的 研究老年心衰患者焦虑、抑郁的发生率和相关因素及对预后的影响,为老年心力衰竭患者的治疗提供依据。 方法 收集2014年6月—2015年6月首都医科大学宣武医院急诊科住院的老年心力衰竭患者225例,应用Zung焦虑自评量表(SAS)和抑郁自评量表(SDS)对心衰患者进行评分,分析焦虑和抑郁的发生率;根据预后分为死亡组49例和存活组176例,应用独立样本t检验,比较死亡组和存活组SAS和SDS评分的区别;根据SAS和SDS评分焦虑患者112例,非焦虑患者113例,抑郁患者168例,非抑郁患者57例,应用χ2检验,分别比较焦虑和抑郁组与非焦虑抑郁组病死率的区别;应用多因素Logistic回归分析研究年龄、性别、收入、心功能、文化程度和独居等因素与焦虑抑郁的相关性。 结果 老年心衰患者的焦虑发生率为63.6%(112/225),抑郁发生率为74.6%(168/225);死亡组患者SAS和SDS评分分别为61.30±6.79和65.32±5.85,存活组的SAS和SDS评分分别为54.06±7.67和55.68±7.62,死亡组患者的SAS和SDS评分均大于存活组,2组比较差异有统计学意义(P=0.001、0.001);焦虑组病死率为41.07%(46/112),非焦虑组的病死率为2.60%(3/113),焦虑组病死率显著大于非焦虑组(χ2=26.83,P=0.001)。抑郁组病死率为27.90%(47/168),非抑郁组的病死率为3.50%(2/57),抑郁组病死率明显大于非抑郁组(χ2=14.95,P=0.001);多因素Logistic回归分析显示焦虑与心功能、文化程度和独居相关(P<0.01),抑郁与心功能和文化程度相关(P<0.05)。 结论 老年心衰患者的抑郁、焦虑的发生率高,并影响患者的预后,应对焦虑、抑郁相关因素进行积极干预。Abstract: Objective To study the incidence and related factors of anxiety and depression in elderly patients with heart failure,explore the effect of anxiety and depression on the prognosis of patients,and provide the basis for the treatment of elderly patients with heart failure. Methods Total 225 elderly patients with heart failure were collected in Xuanwu hospital of Capital Medical University from June,2014 to June,2015.Zung self-rating Anxiety Scale(SAS) and self-rating Depression Scale(SDS) were used to analyze the incidence of anxiety and depression;According to the prognosis,49 cases were divided into death group,176 cases were divided into survival group,t test was used to compare the difference of SDS and SAS score between the death group and the survival group;According to SAS and SDS,112 patients with anxiety,113 patients with no anxiety,168 patients with depression,57 patients with no depression,the application of chi square test were used to compare the difference of SAS and SDS between the anxiety and depression groups and no anxiety and depression groups respectively;The influence of age,gender,income,heart function,culture degree and living alone and other factors on the anxiety and depression were analyzed by using multivariate logistic regression analysis of correlation. Results The incidence of anxiety was 63.6%(112/225)in elderly patients with heart failure,and the incidence of depression was 74.6%(168/225).The SAS and SDS score in the death group were 61.30±6.79 and 65.32±5.85 respectively,the SAS and SDS scores in the survival group were 54.06±7.67 and 55.68±7.62 respectively,the SAS and SDS scores in the death group were higher than those in the survival group,the difference between the two groups was statistically significant(P=0.001,0.001).The mortality rate in anxiety group was 41.07%(46/112),the mortality rate in no anxiety group was 2.6%(3/113),the mortality in the anxiety group was significantly higher than that in no anxiety group(χ2=26.83,P=0.001).The mortality rate in depression group was 27.9%(47/168),the mortality rate in no depression group was 3.5%(2/57),the mortality rate in depression group was significantly higher than that in no depression group(χ2=14.95,P=0.001).Multivariate logistic regression analysis showed that the heart function,alone and the degree of culture were significantly related with the anxiety(P<0.01),the heart function and culture degree were significantly related with depression(P<0.05). Conclusion The incidence of depression and anxiety in elderly patients with heart failure were higher,these could affect the prognosis of patients,the related factors for active intervention should be done to deal with the anxiety and depression.
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Key words:
- Anxiety /
- Depression /
- Elderly patients /
- Heart failure /
- Prognosis
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