Depressive Symptoms and Impaired Physical Function after Acute Lung Injury A 2-Year Longitudinal Study
Depressive Symptoms and Impaired Physical Function after Acute Lung Injury A 2-Year Longitudinal Study
复制标题
DOI：
10.1164/rccm.201103-0503oc
复制
发表时间：
2012-03-01
影响因子：
24.7
通讯作者：
Needham, Dale M.
中科院分区：
文献类型：
--
作者：
Bienvenu, Oscar J.;Colantuoni, Elizabeth;Needham, Dale M.
理由：急性肺损伤的幸存者（全部）经常出现严重的抑郁症状和身体损伤，但这些情况的纵向流行病学仍不清楚。目的：评估 ALI 后抑郁症状和身体损伤的 2 年发生率和持续时间，以及这些情况的危险因素。方法：这项前瞻性纵向队列研究招募了来自 13 个重症监护病房 (ICU) 的患者 在四家医院进行了随访，随访时间为 3、6、12 和 24 个月。结果是，在 ALI 之前没有抑郁病史的患者中，医院焦虑和抑郁量表抑郁评分大于或等于 8（“抑郁症状”）；在没有基线损伤的患者中，日常生活工具性活动（“身体功能受损”）有两种或多种依赖性。 测量和主要结果：在 186 名 ALI 幸存者的 2 年随访期间，抑郁症状和身体功能受损的累积发生率分别为 40% 和 66%， 分别是 3 个月随访时发生率最高；每个结果的模式持续时间均大于 21 个月。发生抑郁症状的危险因素包括受教育年限 12 年或以下、基线残疾或失业、较高的基线医疗合并症以及 ICU 中的较低血糖。发生身体功能受损的危险因素是入住 ICU 时间较长和既往有抑郁症状。结论：在 ALI 后的头 2 年内，发生抑郁症状和身体功能受损很常见且持续时间较长。应评估针对潜在可改变风险因素（例如，早期康复中的严重抑郁症状）的干预措施，以改善所有幸存者的长期结果。
Rationale: Survivors of acute lung injury (All) frequently have substantial depressive symptoms and physical impairment, but the longitudinal epidemiology of these conditions remains unclear.Objectives: To evaluate the 2-year incidence and duration of depressive symptoms and physical impairment after ALI, as well as risk factors for these conditions.Methods: This prospective, longitudinal cohort study recruited patients from 13 intensive care units (ICUs) in four hospitals, with follow-up 3, 6, 12, and 24 months after All. The outcomes were Hospital Anxiety and Depression Scale depression score greater than or equal to 8 ("depressive symptoms") in patients without a history of depression before ALI, and two or more dependencies in instrumental activities of daily living ("impaired physical function") in patients without baseline impairment.Measurements and Main Results: During 2-year follow-up of 186 ALI survivors, the cumulative incidences of depressive symptoms and impaired physical function were 40 and 66%, respectively, with greatest incidence by 3-month follow-up; modal durations were greater than 21 months for each outcome. Risk factors for incident depressive symptoms were education 12 years or less, baseline disability or unemployment, higher baseline medical comorbidity, and lower blood glucose in the ICU. Risk factors for incident impaired physical function were longer ICU stay and prior depressive symptoms.Conclusions: Incident depressive symptoms and impaired physical function are common and long-lasting during the first 2 years after ALI. Interventions targeting potentially modifiable risk factors (e.g., substantial depressive symptoms in early recovery) should be evaluated to improve All survivors' long-term outcomes.