期刊
JOURNAL OF CARDIAC FAILURE
卷 18, 期 3, 页码 238-245出版社
CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS
DOI: 10.1016/j.cardfail.2011.11.002
关键词
Depression; heart failure; Patient Health Questionnaire; mortality
资金
- NCATS NIH HHS [UL1 TR000005] Funding Source: Medline
- NCRR NIH HHS [UL1 RR024153] Funding Source: Medline
- NIMH NIH HHS [R34 MH078030-03, R34 MH078030] Funding Source: Medline
Background: Given the association of depression with poorer cardiac outcomes, an American Heart Association Science Advisory has advocated routine screening of cardiac patients for depression using the 2-item Patient Health Questionnaire (PHQ-2) at a minimum. However, the prognostic value of the PHQ-2 among HF patients is unknown. Methods and Results: We screened hospitalized HF patients (ejection fraction [EF] <40%) that staff suspected may be depressed with the PHQ-2, and then determined vital status at up to 12-months follow-up. At baseline, PHQ-2 depression screen positive patients (PHQ-2+; n = 371), compared with PHQ-2 screen negative patients (PHQ-2; n = 100), were younger (65 vs 70 years) and more likely to report New York Heart Association (NYHA) functional class III/IV than class II symptoms (67% vs. 39%) and lower levels of physical and mental health related quality of life (all P <=.002); they were similar in other characteristics (65% male, 26% mean EF). At 12 months, 20% of PHQ-2+ versus 8% of PHQ-2 patients had died (P = .007) and PHQ-2 status remained associated with both all-cause (hazard ratio [HR] 3.1, 95% confidence interval [CI] 1.4-6.7; P =.003) and cardiovascular (HR 2.7, 95% CI 1.1-6.6; P = .03) mortality even after adjustment for age, gender, EF, NYHA functional class, and a variety of other covariates. Conclusions: Among hospitalized HF patients, a positive PHQ-2 depression screen is associated with an elevated 12-month mortality risk. (J Cardiac Fail 2012;18:238-245)
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