Tags

Type your tag names separated by a space and hit enter

Sex, depression, and risk of hospitalization and mortality in chronic obstructive pulmonary disease.
Arch Intern Med 2007; 167(21):2345-53AI

Abstract

BACKGROUND

We sought to determine whether depressive or anxiety symptoms are associated with chronic obstructive pulmonary disease (COPD) hospitalization or mortality. These data were collected as part of the National Emphysema Treatment Trial (NETT), a randomized controlled trial of lung volume reduction surgery vs continued medical treatment conducted at 17 clinics across the United States between January 29, 1998, and July 31, 2002.

METHODS

Prospective cohort study among participants in the NETT with emphysema and severe airflow limitation who were randomized to medical therapy. Primary outcomes were 1- and 3-year mortality, as well as COPD or respiratory-related hospitalization or emergency department visit during the 1-year follow-up period. Of 610 patients randomized to medical therapy, complete data on hospitalization and mortality were available for 3 years of follow-up for 603 patients (98.9%).

RESULTS

Depressive symptoms were assessed using the Beck Depression Inventory (BDI) questionnaire, and anxiety was assessed using the State-Trait Anxiety Inventory. Among 610 subjects, 40.8% had at least mild to moderate depressive symptoms. Patients in the highest quintile of BDI score (BDI score, >or=15) had an increased risk of respiratory hospitalization in unadjusted analysis compared with patients in the lowest quintile (BDI score, < 5) (odds ratio [OR], 2.26; 95% confidence interval [CI], 1.30-3.93). After adjustment for disease severity, this relationship was no longer statistically significant. The adjusted risk of 3-year mortality was increased among those in the highest quintile of BDI score (OR, 2.74; 95% CI, 1.42-5.29) compared with those in the lowest quintile. Anxiety was not associated with hospitalization or mortality in this population.

CONCLUSIONS

Depressive symptoms are common in patients with severe COPD and are treated in few subjects. Depressive symptoms are associated with increased risk for 3-year mortality but not 1-year mortality or hospitalization.

Authors+Show Affiliations

Health Services Research and Development Center of Excellence, Veterans Affairs Puget Sound Health Care System, 1660 S Columbian Way, Seattle, WA 98108-1597, USA. vfan@u.washington.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

18039994

Citation

Fan, Vincent S., et al. "Sex, Depression, and Risk of Hospitalization and Mortality in Chronic Obstructive Pulmonary Disease." Archives of Internal Medicine, vol. 167, no. 21, 2007, pp. 2345-53.
Fan VS, Ramsey SD, Giardino ND, et al. Sex, depression, and risk of hospitalization and mortality in chronic obstructive pulmonary disease. Arch Intern Med. 2007;167(21):2345-53.
Fan, V. S., Ramsey, S. D., Giardino, N. D., Make, B. J., Emery, C. F., Diaz, P. T., ... Martinez, F. J. (2007). Sex, depression, and risk of hospitalization and mortality in chronic obstructive pulmonary disease. Archives of Internal Medicine, 167(21), pp. 2345-53.
Fan VS, et al. Sex, Depression, and Risk of Hospitalization and Mortality in Chronic Obstructive Pulmonary Disease. Arch Intern Med. 2007 Nov 26;167(21):2345-53. PubMed PMID: 18039994.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Sex, depression, and risk of hospitalization and mortality in chronic obstructive pulmonary disease. AU - Fan,Vincent S, AU - Ramsey,Scott D, AU - Giardino,Nicholas D, AU - Make,Barry J, AU - Emery,Charles F, AU - Diaz,Phillip T, AU - Benditt,Joshua O, AU - Mosenifar,Zab, AU - McKenna,Robert,Jr AU - Curtis,Jeffrey L, AU - Fishman,Alfred P, AU - Martinez,Fernando J, AU - ,, PY - 2007/11/28/pubmed PY - 2008/1/25/medline PY - 2007/11/28/entrez SP - 2345 EP - 53 JF - Archives of internal medicine JO - Arch. Intern. Med. VL - 167 IS - 21 N2 - BACKGROUND: We sought to determine whether depressive or anxiety symptoms are associated with chronic obstructive pulmonary disease (COPD) hospitalization or mortality. These data were collected as part of the National Emphysema Treatment Trial (NETT), a randomized controlled trial of lung volume reduction surgery vs continued medical treatment conducted at 17 clinics across the United States between January 29, 1998, and July 31, 2002. METHODS: Prospective cohort study among participants in the NETT with emphysema and severe airflow limitation who were randomized to medical therapy. Primary outcomes were 1- and 3-year mortality, as well as COPD or respiratory-related hospitalization or emergency department visit during the 1-year follow-up period. Of 610 patients randomized to medical therapy, complete data on hospitalization and mortality were available for 3 years of follow-up for 603 patients (98.9%). RESULTS: Depressive symptoms were assessed using the Beck Depression Inventory (BDI) questionnaire, and anxiety was assessed using the State-Trait Anxiety Inventory. Among 610 subjects, 40.8% had at least mild to moderate depressive symptoms. Patients in the highest quintile of BDI score (BDI score, >or=15) had an increased risk of respiratory hospitalization in unadjusted analysis compared with patients in the lowest quintile (BDI score, < 5) (odds ratio [OR], 2.26; 95% confidence interval [CI], 1.30-3.93). After adjustment for disease severity, this relationship was no longer statistically significant. The adjusted risk of 3-year mortality was increased among those in the highest quintile of BDI score (OR, 2.74; 95% CI, 1.42-5.29) compared with those in the lowest quintile. Anxiety was not associated with hospitalization or mortality in this population. CONCLUSIONS: Depressive symptoms are common in patients with severe COPD and are treated in few subjects. Depressive symptoms are associated with increased risk for 3-year mortality but not 1-year mortality or hospitalization. SN - 0003-9926 UR - https://www.unboundmedicine.com/medline/citation/18039994/Sex_depression_and_risk_of_hospitalization_and_mortality_in_chronic_obstructive_pulmonary_disease_ L2 - https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/archinte.167.21.2345 DB - PRIME DP - Unbound Medicine ER -