A positive 2-item Patient Health Questionnaire depression screen among hospitalized heart failure patients is associated with elevated 12-month mortality.
A positive 2-item Patient Health Questionnaire depression screen among hospitalized heart failure patients is associated with elevated 12-month mortality.
复制标题
住院心力衰竭患者的 2 项患者健康问卷抑郁筛查呈阳性与 12 个月死亡率升高相关。
DOI：
10.1016/j.cardfail.2011.11.002
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发表时间：
2012
影响因子：
6
通讯作者：
McNamara,DennisM
中科院分区：
文献类型：
--
作者：
Rollman,BruceL;HerbeckBelnap,Bea;Mazumdar,Sati;Houck,PatriciaR;He,Fanyin;Alvarez,ReneJ;Schulberg,HerbertC;Reynolds3rd,CharlesF;McNamara,DennisM
背景鉴于抑郁症与较差的心脏结局之间的关联，美国心脏协会的一项科学咨询主张常规地使用两项患者健康问卷(PHQ-2)来筛查心脏病患者的抑郁症。然而，PHQ-2在心力衰竭患者中的预后价值尚不清楚。方法和结果我们筛查了工作人员怀疑可能患有PHQ-2抑郁的住院心衰患者(射血分数(EF)和40%)，并在长达12个月的随访中确定了生命状态。在基线时，PHQ-2抑郁症筛查阳性患者(PHQ-2(+)；N=371)与PHQ-2筛查阴性患者(PHQ-2(−)；N=100)相比更年轻(65比70)，更有可能报告NYHAIII/IV级而不是II级症状(67%比39%)，以及较低的与身体和精神健康相关的生活质量水平(均p≤0.002)，但在其他特征上相似(65%男性，26%平均EF)。在12个月时，PHQ-2(+)患者的死亡率为20%，而PHQ-2(−)患者的死亡率为8%(p=0.007)，即使在调整了年龄、性别、EF、NYHA分级和各种其他协变量后，phq-2状态仍然与各种原因(风险比(HR)：3.1(95%可信区间：1.4-6.7)；p=0.003)和心血管死亡率(HR：2.7(1.1-6.6)；p=0.03)有关。结论：在住院的心衰患者中，PHQ-2抑郁筛查阳性与12个月死亡风险升高相关。
Background Given the association of depression with poorer cardiac outcomes, an American Heart Association Science Advisory has advocated routinly screening cardiac patients for depression using the two-item Patient Health Questionnaire (PHQ-2) “at a minimum.” Yet, the prognostic value of the PHQ-2 among HF patients is unknown. Methods and Results We screened hospitalized HF patients (ejection fraction (EF) <40%) that staff suspected may be depressed with the PHQ-2, and then determined vital status at up to 12-months follow-up. At baseline, PHQ-2 depression-screen positive patients (PHQ-2 (+); N=371) compared to PHQ-2 screen-negative patients (PHQ-2 (−); N=100) were younger (65 vs. 70), and more likely to report NYHA class III/IV than class II symptoms (67% vs. 39%) and lower levels of physical and mental health-related quality of life (all p ≤ 0.002), but were similar on other characteristics (65% male, 26% mean EF). At 12-months, 20% of PHQ-2 (+) vs. 8% of PHQ-2 (−) patients had died (p=0.007) and PHQ-2 status remained associated with both all-cause (hazard ratio (HR): 3.1 (95% CI: 1.4–6.7); p=0.003) and cardiovascular mortality (HR: 2.7 (1.1–6.6); p=0.03) even after adjustment for age, gender, EF, NYHA class, and a variety of other covariates. Conclusions Among hospitalized HF patients, a positive PHQ-2 depression screen is associated with an elevated 12-month mortality risk.