Does depression in older medical inpatients predict mortality? A systematic review
Does depression in older medical inpatients predict mortality? A systematic review
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DOI：
10.1016/j.genhosppsych.2007.07.002
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发表时间：
2007-09-01
影响因子：
7
通讯作者：
Cole, Martin G.
中科院分区：
文献类型：
--
作者：
Cole, Martin G.
目的：确定老年内科住院患者的抑郁是否可以预测死亡率。方法：检索Medline、QicINFO、Embase和Cochrane系统综述数据库中潜在的相关文章；检索相关文献的书目以获得更多参考文献。对检索到的研究进行筛选，以满足五项纳入标准。根据循证医学工作组采用的四个标准对研究的有效性进行评估。从每项研究中提取数据并将其制成表格。数据综合涉及定性的荟萃分析。结果：许多研究都有方法学上的局限性。6人报告抑郁症导致死亡率上升，5人报告抑郁症不能预测死亡率，1人报告有抑郁症病史时死亡率下降。未调整的死亡风险比从0.60到12.6；调整后的风险比从0.42到7.4。这些不同的发现可能部分是由于年轻的老年患者和参加不同研究的男性比例的差异。结论：老年内科住院患者抑郁预测死亡率的证据并不确定。有必要进行更深入的研究，关注设计、人口登记和分析。(C)2007 Elsevier Inc.保留所有权利。
Objective: To determine whether depression in older medical inpatients predicts mortality.Method: Medline, PsycINFO, Embase, and the Cochrane Database of Systematic Reviews were searched for potentially relevant articles; the bibliographies of relevant articles were searched for additional references. Retrieved studies were screened to meet five inclusion criteria. Validity of studies was assessed according to four criteria adapted from the Evidence-Based Medicine Working Group. Data were abstracted from each study and tabulated. Data synthesis involved a qualitative meta-analysis.Results: Many of the studies had methodological limitations. Six reported that depression predicted increased mortality, five reported that depression did not predict mortality, and one reported that depression predicted decreased mortality when there was a history of prior depression. Unadjusted risk ratios for death ranged from 0.60 to 12.6; adjusted risk ratios ranged from 0.42 to 7.4. The disparate findings may be explained in part by differences in the proportions of young older patients and men enrolled in the different studies.Conclusion: The evidence that depression in older medical inpatients predicts mortality is inconclusive. There is a need for further studies that pay attention to design, populations enrolled, and analysis. (C) 2007 Elsevier Inc. All rights reserved.