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Crit Care Med:近1/3的ICU出院患者有抑郁症状

2016-09-08 Mechront 译 MedSci原创

研究者检索了PubMed、EMBASE、PsycINFO等数据库,纳入了重症监护室出院后,抑郁症状发生情况相关研究(超过20人,使用验证的测量工具识别抑郁症状),进行系统回顾和荟萃分析。 最终42篇符合条件的文献,涉及38项独立研究,共对4113名患者进行了系统回顾和合并后荟萃分析。最常使用的予以量表是医院焦虑抑郁量表(58%)。出院后2-3个月(12项研究;n = 1078),合并后医院焦

研究者检索了PubMed、EMBASE、PsycINFO等数据库,纳入了重症监护室出院后,抑郁症状发生情况相关研究(超过20人,使用验证的测量工具识别抑郁症状),进行系统回顾和荟萃分析。

最终42篇符合条件的文献,涉及38项独立研究,共对4113名患者进行了系统回顾和合并后荟萃分析。最常使用的予以量表是医院焦虑抑郁量表(58%)。出院后2-3个月(12项研究;n = 1078),合并后医院焦虑抑郁量表得分≥8分的患者有29% (22-36%);出院后6个月时(7项研究;n = 760),发生率为34% (24-43%);出院后12-114个月时(6项研究;n = 1041),发生率为29% (23-34%)。

所有的研究中,医院焦虑抑郁量表得分≥8分的抑郁症状在三个时间点的发生率位于29%和30%之间。合并后从出院后2-3个月到6个月的发生率变化为5% (-1% to +12%)(4项研究; n = 387);从出院后6个月到12个月的变化为1% (-6% to +7%)(三项研究; n = 412)。

ICU出院后患抑郁症状的危险因素包括:入住ICU之前有精神病、ICU期间有心理困扰症状。目前研究者没有发现改善抑郁症状的强有力的出院后干预。

结果表明,近三分之一的ICU出院患者有抑郁症状,且持续随访的12个月。对这一常见且持久的ICU出院后抑郁症状需要更多的研究和治疗。

原始出处:

Rabiee A.et al.Depressive Symptoms After Critical Illness: A Systematic Review and Meta-Analysis.Crit Care Med. 2016 Sep;44(9):1744-53.

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createdName=知难而进, createdTime=Fri Sep 09 10:52:00 CST 2016, time=2016-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=114990, encodeId=b6f3114990c2, content=谢谢分享!!!!!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Fri Sep 09 10:52:00 CST 2016, time=2016-09-09, status=1, ipAttribution=)]
    2016-10-12 1e10c84am36(暂无匿称)

    好文章,受益

    0

  2. 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createdName=知难而进, createdTime=Fri Sep 09 10:52:00 CST 2016, time=2016-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=114990, encodeId=b6f3114990c2, content=谢谢分享!!!!!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Fri Sep 09 10:52:00 CST 2016, time=2016-09-09, status=1, ipAttribution=)]
    2016-09-29 xmax889

    目前这种状态,我个人觉得ICU抑郁的发生率挺高的

    0

  3. 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createdName=知难而进, createdTime=Fri Sep 09 10:52:00 CST 2016, time=2016-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=114990, encodeId=b6f3114990c2, content=谢谢分享!!!!!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Fri Sep 09 10:52:00 CST 2016, time=2016-09-09, status=1, ipAttribution=)]
    2016-09-19 李东泽

    很好,不错,以后会多学习

    0

  4. 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00:02:24 CST 2016, time=2016-09-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=130930, encodeId=8936130930b2, content=很好,不错,以后会多学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Mon Sep 19 16:30:00 CST 2016, time=2016-09-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=127366, encodeId=527412e3661e, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Thu Sep 15 09:54:00 CST 2016, time=2016-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=127367, encodeId=a04c12e36773, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=118, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Thu Sep 15 09:54:00 CST 2016, time=2016-09-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1434870, encodeId=52ae14348e0ee, content=<a href='/topic/show?id=952a54980e5' target=_blank style='color:#2F92EE;'>#抑郁症状#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=54980, encryptionId=952a54980e5, topicName=抑郁症状)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Sat Sep 10 07:25:00 CST 2016, time=2016-09-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1607083, encodeId=adc7160e0836e, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Sat Sep 10 07:25:00 CST 2016, time=2016-09-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=114992, encodeId=0863114992da, content=继续关注!!!!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Fri Sep 09 10:53:00 CST 2016, time=2016-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=114988, encodeId=e19c114988b7, content=为什么会出现抑郁症, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Fri Sep 09 10:52:00 CST 2016, time=2016-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=114990, encodeId=b6f3114990c2, content=谢谢分享!!!!!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Fri Sep 09 10:52:00 CST 2016, time=2016-09-09, status=1, ipAttribution=)]
    2016-09-15 doctorJiangchao

    继续学习

    0

  5. 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createdName=知难而进, createdTime=Fri Sep 09 10:52:00 CST 2016, time=2016-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=114990, encodeId=b6f3114990c2, content=谢谢分享!!!!!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Fri Sep 09 10:52:00 CST 2016, time=2016-09-09, status=1, ipAttribution=)]
    2016-09-15 doctorJiangchao

    继续关注

    0

  6. 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createdName=知难而进, createdTime=Fri Sep 09 10:52:00 CST 2016, time=2016-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=114990, encodeId=b6f3114990c2, content=谢谢分享!!!!!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Fri Sep 09 10:52:00 CST 2016, time=2016-09-09, status=1, ipAttribution=)]
  7. 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createdName=ms3994565386320060, createdTime=Sat Sep 10 07:25:00 CST 2016, time=2016-09-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=114992, encodeId=0863114992da, content=继续关注!!!!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Fri Sep 09 10:53:00 CST 2016, time=2016-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=114988, encodeId=e19c114988b7, content=为什么会出现抑郁症, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Fri Sep 09 10:52:00 CST 2016, time=2016-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=114990, encodeId=b6f3114990c2, content=谢谢分享!!!!!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Fri Sep 09 10:52:00 CST 2016, time=2016-09-09, status=1, ipAttribution=)]
  8. 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00:02:24 CST 2016, time=2016-09-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=130930, encodeId=8936130930b2, content=很好,不错,以后会多学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Mon Sep 19 16:30:00 CST 2016, time=2016-09-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=127366, encodeId=527412e3661e, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, 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createdName=ms3994565386320060, createdTime=Sat Sep 10 07:25:00 CST 2016, time=2016-09-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=114992, encodeId=0863114992da, content=继续关注!!!!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Fri Sep 09 10:53:00 CST 2016, time=2016-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=114988, encodeId=e19c114988b7, content=为什么会出现抑郁症, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Fri Sep 09 10:52:00 CST 2016, time=2016-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=114990, encodeId=b6f3114990c2, content=谢谢分享!!!!!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Fri Sep 09 10:52:00 CST 2016, time=2016-09-09, status=1, ipAttribution=)]
    2016-09-09 知难而进

    继续关注!!!!!

    0

  9. 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00:02:24 CST 2016, time=2016-09-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=130930, encodeId=8936130930b2, content=很好,不错,以后会多学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Mon Sep 19 16:30:00 CST 2016, time=2016-09-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=127366, encodeId=527412e3661e, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, 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createdName=知难而进, createdTime=Fri Sep 09 10:52:00 CST 2016, time=2016-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=114990, encodeId=b6f3114990c2, content=谢谢分享!!!!!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Fri Sep 09 10:52:00 CST 2016, time=2016-09-09, status=1, ipAttribution=)]
    2016-09-09 知难而进

    为什么会出现抑郁症

    0

  10. 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createdName=知难而进, createdTime=Fri Sep 09 10:52:00 CST 2016, time=2016-09-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=114990, encodeId=b6f3114990c2, content=谢谢分享!!!!!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=79, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160811/IMG57AC91915ACA64463.jpg, createdBy=9c351934462, createdName=知难而进, createdTime=Fri Sep 09 10:52:00 CST 2016, time=2016-09-09, status=1, ipAttribution=)]
    2016-09-09 知难而进

    谢谢分享!!!!!!

    0

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香港医院的ICU竟然是这样的!

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J Am Geriatr Soc:在自身生命的最后一个月,有多少医生会选择临终关怀?

根据发表在Journal of the American Geriatrics Society的研究表明,与普通人群相比,美国的医生更倾向于在他们生命的最后一个月使用临终关怀,重症护理或重症监护病房。科 罗拉多大学的Daniel D. Matlock博士和同事进行了一项回顾性队列研究,纳入9947名生前为医生的死者和192006的享有医疗保险的死者,均为有偿服务的医疗保险受益 人。他们使用

JAMA:与常规治疗相比SRT并不会减少急性呼吸衰竭患者的住院时间

重症监护病房(ICU)的物理康复治疗可改善急性呼吸衰竭患者的预后。本研究旨在对比急性呼吸衰竭的护理中标准的康复治疗(SRT)与常规ICU护理的差异。采用单中心随机临床试验设计,地点在北卡罗来纳州威克森林浸信会医疗中心。纳入入住ICU的患有急性呼吸衰竭需要机械通气的成年患者(平均年龄58岁;女性,55%),随机分为SRT(n = 150)或常规治疗(n = 150),随访6个月。SRT组患者每天接受

JAMA:重症急性肾损伤究竟要不要早期进行肾脏替代治疗?

对没有生命危险的重症急性肾损伤(AKI)患者何时进行肾脏替代治疗(RRT)仍存在争议。因此研究者进行了一项研究,探究早期RRT能否减少危重AKI患者的90天全因死亡率。 该单中心随机临床试验在2013年8月至2015年6月从德国的一个大学医院纳入了231名危重AKI患者,所有患者为改善全球预后(KDIGO)分级至少为2阶段(≥基线2倍或≥12小时尿量<0.5 mL/kg/h)和血浆

生死之间隔着一个ICU

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Nutr J:ICU患者谷氨酰胺水平低于正常?

谷氨酰胺缺乏是重症监护病房(ICU)患者死亡率的独立预测因素,不过补充谷氨酰胺能改善患者益处,因此被常规推荐。然而,最近的数据表明,在某些患者组,然而,最近的数据表明,会增加某些患者的死亡率。本研究的目的是调查在南非的成人重症监护病房患者的血浆谷氨酰胺水平,并确定谷氨酰胺水平、性别、诊断类别和选定的炎症标志物之间的关系。这项研究的数据将被用来作为基线测量,以支持将对南非重症监护病房患者进行的大规模

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