Younger Adults Initiating Hemodialysis: Antidepressant Use for Depression Associated With Higher Health Care Utilization.

Autor:	Vork DL; Mayo Medical School, Mayo Clinic, Rochester, MN., Schneekloth TD; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN., Bartley AC; Department of Health Sciences Research, Mayo Clinic, Rochester, MN., Vaughan LE; Department of Health Sciences Research, Mayo Clinic, Rochester, MN., Lapid MI; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN., Jowsey-Gregoire SG; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN., El-Zoghby ZM; Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN., Herrmann SM; Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN., Tran CL; Division of Pediatric Nephrology, Department of Pediatrics, Mayo Clinic, Rochester, MN., Albright RC; Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN., Hickson LJ; Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN; Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN. Electronic address: Hickson.latonya@mayo.edu.
Jazyk:	angličtina
Zdroj:	Mayo Clinic proceedings [Mayo Clin Proc] 2018 Mar; Vol. 93 (3), pp. 321-332.
DOI:	10.1016/j.mayocp.2017.12.008
Abstrakt:	Objective: To examine associations between antidepressant use and health care utilization in young adults beginning maintenance hemodialysis (HD) therapy. Patients and Methods: Antidepressant use, hospitalizations, and emergency department (ED) visits were examined in young adults (N=130; age, 18-44 years) initiating HD (from January 1, 2001, through December 31, 2013) at a midwestern US institution. Primary outcomes included hospitalizations and ED visits during the first year. Results: Depression diagnosis was common (47; 36.2%) at HD initiation, yet only 28 patients (21.5%) in the cohort were receiving antidepressant therapy. The antidepressant use group was more likely to have diabetes mellitus (18 [64.3%] vs 33 [32.4%]), coronary artery disease (8 [28.6%] vs 12 [11.8%]), and heart failure (9 [32.1%] vs 15 [14.7%]) (P<.05 for all) than the untreated group. Overall, 68 (52.3%) had 1 or more hospitalizations and 33 (25.4%) had 1 or more ED visits in the first year. The risk of hospitalization during the first year was higher in the antidepressant use group (hazard ratio, 2.35; 95% CI, 1.39-3.96; P=.001), which persisted after adjustment for diabetes, coronary artery disease, and heart failure (hazard ratio, 1.94; 95% CI, 1.22-3.10; P=.006). Emergency department visit rates were similar between the groups. Conclusion: Depression and antidepressant use for mood indication are common in young adult incident patients initiating HD and and are associated with higher hospitalization rates during the first year. Further research should determine whether antidepressants are a marker for other comorbidities or whether treated depression affects the increased health care use in these individuals. (Copyright © 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu