Symptoms of depression in survivors of severe sepsis: a prospective cohort study of older Americans.

TitleSymptoms of depression in survivors of severe sepsis: a prospective cohort study of older Americans.
Publication TypeJournal Article
Year of Publication2013
AuthorsDavydow, DS, Hough, CL, Langa, KM, Iwashyna, TJ
JournalAm J Geriatr Psychiatry
Volume21
Issue9
Pagination887-97
Date Published2013 Sep
ISSN Number1545-7214
KeywordsAged, Aged, 80 and over, Cohort Studies, depression, Female, Hospitalization, Humans, Longitudinal Studies, Male, Poisson Distribution, Prospective Studies, Regression Analysis, Risk Factors, Sepsis, Severity of Illness Index, Survivors, United States
Abstract

<p><b>OBJECTIVES: </b>To examine if incident severe sepsis is associated with increased risk of subsequent depressive symptoms and to assess which patient characteristics are associated with increased risk of depressive symptoms.</p><p><b>DESIGN: </b>Prospective longitudinal cohort study.</p><p><b>SETTING: </b>Population-based cohort of older U.S. adults interviewed as part of the Health and Retirement Study (1998-2006).</p><p><b>PARTICIPANTS: </b>A total of 439 patients who survived 471 hospitalizations for severe sepsis and completed at least one follow-up interview.</p><p><b>MEASUREMENTS: </b>Depressive symptoms were assessed with a modified version of the Center for Epidemiologic Studies Depression Scale. Severe sepsis was identified using a validated algorithm in Medicare claims.</p><p><b>RESULTS: </b>The point prevalence of substantial depressive symptoms was 28% at a median of 1.2 years before sepsis, and remained 28% at a median of 0.9 years after sepsis. Neither incident severe sepsis (relative risk [RR]: 1.00; 95% confidence interval [CI]: 0.73, 1.34) nor severe sepsis-related clinical characteristics were significantly associated with subsequent depressive symptoms. These results were robust to potential threats from missing data or alternative outcome definitions. After adjustment, presepsis substantial depressive symptoms (RR: 2.20; 95% CI: 1.66, 2.90) and worse postsepsis functional impairment (RR: 1.08 per new limitation; 95% CI: 1.03, 1.13) were independently associated with substantial depressive symptoms after sepsis.</p><p><b>CONCLUSIONS: </b>The prevalence of substantial depressive symptoms in severe sepsis survivors is high but is not increased relative to their presepsis levels. Identifying this large subset of severe sepsis survivors at increased risk for major depression, and beginning interventions before hospital discharge, may improve outcomes.</p>

Notes

Times Cited: 0

DOI10.1016/j.jagp.2013.01.017
User Guide Notes

http://www.ncbi.nlm.nih.gov/pubmed/23567391?dopt=Abstract

Endnote Keywords

Critical care/Depression/Outcome assessment (healthcare)/Sepsis/health Care Utilization/HOSPITALIZATION

Endnote ID

69138

Alternate JournalAm J Geriatr Psychiatry
Citation Key7839
PubMed ID23567391
PubMed Central IDPMC3462893
Grant ListU01 AG009740 / AG / NIA NIH HHS / United States
R01 AG030155 / AG / NIA NIH HHS / United States
R01 HL096504 / HL / NHLBI NIH HHS / United States
T32/MH20021-12 / MH / NIMH NIH HHS / United States
U01 AG09740 / AG / NIA NIH HHS / United States
KL2 RR025015 / RR / NCRR NIH HHS / United States
T32 MH020021 / MH / NIMH NIH HHS / United States
K08 HL091249-03 / HL / NHLBI NIH HHS / United States
K08 HL091249 / HL / NHLBI NIH HHS / United States