PDF(Pubmed)
Abstract：
Modern intensive care has improved survival rates, but emerging evidence suggests a high prevalence of post-intensive care unit (ICU) health problems, including post-traumatic stress disorder, depression and anxiety. These symptoms may have a detrimental effect on quality of life and increase mortality. The primary objective of this study is to examine the extent of initiation of antidepressant medication among ICU survivors and identify the factors associated with its usage. The secondary objective is to investigate whether the use of these medications is linked to an increased mortality. The nationwide study cohort included 125,130 ICU survivors admitted between 2010 and 2017. Within the first 3 months after ICU discharge, 7% of patients initiated antidepressant medication, by 1 year 15.5% had started medication. We found no tendency to a decrease during the 2-year follow-up period. Factors associated with antidepressant use included middle age, female sex, psychiatric and somatic comorbid conditions, substance dependence, higher illness severity, and longer ICU stay. Antidepressant users had a higher mortality rate, and deaths due to external causes and suicide were more frequent in this group. This study emphasizes the importance of detecting and addressing depression in ICU survivors to improve their quality of life and reduce mortality rates.
摘要：
现代重症监护提高了生存率，但是新出现的证据表明，重症监护病房（ICU）后健康问题的患病率很高，包括创伤后应激障碍,抑郁和焦虑。这些症状可能对生活质量产生不利影响并增加死亡率。这项研究的主要目的是检查ICU幸存者开始抗抑郁药物治疗的程度，并确定与其使用相关的因素。次要目标是调查这些药物的使用是否与死亡率增加有关。全国范围的研究队列包括2010年至2017年间收治的125,130名ICU幸存者。在ICU出院后的前3个月内，7%的患者开始服用抗抑郁药物，到1年，15.5%的人开始用药。在2年的随访期间，我们没有发现下降的趋势。与抗抑郁药使用相关的因素包括中年，女性性别,精神病和躯体合并症，物质依赖，疾病严重程度更高，ICU逗留时间更长。抗抑郁药使用者的死亡率更高，在该组中，由于外部原因导致的死亡和自杀更为频繁。这项研究强调了在ICU幸存者中检测和解决抑郁症的重要性，以改善他们的生活质量并降低死亡率。
