Antidepressant-treated patients in ambulatory care - Mortality during a nine-year period after first treatment
Antidepressant-treated patients in ambulatory care - Mortality during a nine-year period after first treatment
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DOI：
10.1192/bjp.169.5.647
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发表时间：
1996-11-01
影响因子：
10.5
通讯作者：
Wicknertz, K
中科院分区：
文献类型：
--
作者：
Bingefors, K;Isacson, D;Wicknertz, K
背景接受抗抑郁药治疗的非住院患者已被证明具有普遍脆弱性的指标，例如高卫生服务使用率和过度使用处方药。因此，该患者组的死亡率值得关注。在一个定义的人群中，在五年的时间内，所有首次发病的抗抑郁药使用者被确定。他们的总死亡率在9年的随访进行了分析。采用考克斯比例风险回归分析总死亡率和心血管疾病死亡率，控制基线慢性内科疾病。即使在控制了预先存在的慢性医学疾病的情况下，在索引日期接受抗抑郁治疗是65岁以上人群长期死亡率增加的统计学显著预测因素。基线缺血性心脏病和同时抗抑郁药治疗显著预测心血管原因的死亡率。处方抗抑郁药治疗可识别有死亡率增加风险的患者。对于门诊医生来说，了解病人的抗抑郁治疗史可能是管理病人护理的一个有价值的工具。
Background. Non-institutionalised patients treated with antidepressants have been shown to have indicators of a generalised vulnerability, such as high rates of health service use and excessive prescription drug use. Therefore, mortality in this patient group is of interest.Method. All first-incidence antidepressant users in a defined population during a five-year period were identified. Their total mortality during a nine-year follow-up was analysed. Cox proportional hazards regression was used to analyse total mortality, and mortality in cardiovascular disease, controlling for baseline chronic medical disease.Results. Antidepressant treatment at the index date was a statistically significant predictor for increased long-term mortality in the over-65s, even when controlling for pre-existing chronic medical disease. Baseline ischaemic heart disease and concurrent antidepressant treatment significantly predicted mortality from cardiovascular causes.Conclusion. Prescribed antidepressant treatment identifies patients who are at risk of increased mortality. For the physician in ambulatory care, knowledge of a patient's antidepressant treatment history may be a valuable tool in managing patient care.