Acute Exacerbations of Chronic Obstructive Pulmonary Disease and the Effect of Existing Psychiatric Comorbidity on Subsequent Mortality
Acute Exacerbations of Chronic Obstructive Pulmonary Disease and the Effect of Existing Psychiatric Comorbidity on Subsequent Mortality
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DOI：
10.1016/j.psym.2011.03.005
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发表时间：
2011-09-01
期刊：
影响因子：
3.4
通讯作者：
Vander Weg, Mark W.
中科院分区：
文献类型：
--
作者：
Abrams, Thad E.;Vaughan-Sarrazin, Mary;Vander Weg, Mark W.
目的：研究慢性阻塞性肺疾病(COPD)预后与精神疾病合并症之间的关系的研究结果喜忧参半。我们调查了全国住院的COPD患者样本，以评估三种精神疾病对死亡率和再入院的影响。方法：使用退伍军人事务部(VA)的管理和实验室数据来确定：2006年10月至2008年9月期间连续收治的26,591名COPD患者。分别使用广义估计方程和Cox比例风险回归分析精神疾病共病与30天死亡率和再入院之间的关系，并对患者人口统计学、医疗合并症、疾病严重程度和医院内的聚集性进行调整。结果：焦虑(5.3%比3.8%[P<；0.001])和抑郁(6.2%比3.8%[P<；100])患者的30天未校正死亡率更高。
Objectives: Studies investigating associations between chronic obstructive pulmonary disease (COPD) outcomes and psychiatric comorbidity have yielded mixed findings. We examined a national sample of hospitalized COPD patients to evaluate the impact of three psychiatric conditions on mortality and readmission. Methods: Department of Veterans Affairs (VA) administrative and laboratory data were used to identify; 26,591 consecutive patients admitted for COPD during October 2006 to September 2008. Associations between psychiatric comorbidity and both 30-day mortality and readmission were examined using generalized estimating equations and Cox proportional hazards regression, respectively, with adjustments for patient demographics, medical comorbidities, illness severity, and clustering within hospitals. Results: Unadjusted 30-day mortality was higher in patients with anxiety (5.3% vs. 3.8% [P < 0.001]) and depression (6.2% vs. 3.8% [