Tratamiento antidepresivo y asociación con el ingreso urgente en unidades médicas en pacientes de 65 años o mayores / Association of antidepressant treatment with emergency admission to medical units for patients 65 years or older

Introducción. Existe una creciente evidencia acerca de la interrelación entre presencia de depresión en la tercera edad y riesgo de ingreso hospitalario médico. Objetivo. Determinar el impacto del tratamiento antidepresivo (ATD) como factor protector de ingreso hospitalario desde Urgencias en personas mayores. Método. Se incluyó a personas de 65 años o mayores que acudieron por cualquier motivo a Urgencias de la Corporació Sanitària i Universitària Parc Taulí de Sabadell (Barcelona) entre enero y octubre del 2012. Se obtuvieron datos sociodemográficos básicos, consumo de alcohol y tabaco, antecedentes y tratamiento actual. Se realizó el cálculo de tamaño muestral y una aleatorización simple. Posteriormente se realizó un análisis estadístico descriptivo y pruebas paramétricas. Resultados. Se evaluó a 674 pacientes (53% mujeres), con una edad media de 78,45 años. Un 27,6% de los casos (71% mujeres) recibían tratamiento antidepresivo. Del total de 337 pacientes ingresados (50%), 83 individuos (24,6%) utilizaban previamente ATD, mientras que entre los no ingresados, utilizaban ATD el 30,6%. Tras el análisis comparativo, se objetivó una relación significativa negativa entre recibir ATD y riesgo de ingreso solo en aquellos pacientes de 75 años o mayores (sig. 0,012). Conclusiones. En nuestro estudio, el tratamiento antidepresivo se relaciona con una disminución del riesgo de ingreso hospitalario urgente por enfermedad médica en personas de 75 años o mayores. El tratamiento de la depresión en personas mayores podría tener efecto protector general frente a la severidad de las enfermedades atendidas en Urgencias en nuestra población y puede suponer un criterio de calidad en orden a prevenir complicaciones (AU)

Introduction. There is increasing evidence relating the presence of depression in seniors and the risk of hospital admission in medical departments from the Emergency Services. Objective. To determine the impact of antidepressant treatment (ATD) as a protective factor for emergency hospitalization in older people. Method. All patients aged 65 and over who required urgent attention for medical reasons at the Emergency Department of the Corporació Sanitària i Universitària Parc Taulí (Sabadell, Barcelona, Spain) for the period between January and October 2012 were included in the study. Sociodemographic variables, alcohol and tobacco use, medical history and psychopharmacological treatment were obtained. The necessary sample size was calculated and a simple randomization was performed. Subsequently, a descriptive statistical analysis and parametric tests were conducted. Results. A total of 674 patients (53% women) were evaluated, with a mean age of 78.45 years, and 27.6% of the cases (71% women) were receiving ATD. Among the 333 admitted patients (50%), 83 individuals (24.6%) had previously received ATD; this contrasts with the 103 cases (30.6%) of prior ATD treatment among the patients who were not admitted. After comparative analysis, the relationship between previous use of ATD and being admitted to hospital was not statistically significant in our global sample. This relationship was only statistically significant among the group aged 75 and over (neg. sig. 0.012). Conclusions. In our study, ATD was associated with a decreased risk of hospital admission for urgent medical conditions in people aged 75 and over. Treating depression may protect the elderly against admission to the Emergency department and may potentially be a quality criterion in preventing complications in this population (AU)

Association of antidepressant treatment with emergency admission to medical units for patients 65 years or older. / Tratamiento antidepresivo y asociación con el ingreso urgente en unidades médicas en pacientes de 65 años o mayores.

INTRODUCTION: There is increasing evidence relating the presence of depression in seniors and the risk of hospital admission in medical departments from the Emergency Services. OBJECTIVE: To determine the impact of antidepressant treatment (ATD) as a protective factor for emergency hospitalization in older people. METHOD: All patients aged 65 and over who required urgent attention for medical reasons at the Emergency Department of the Corporació Sanitària i Universitària Parc Taulí (Sabadell, Barcelona, Spain) for the period between January and October 2012 were included in the study. Sociodemographic variables, alcohol and tobacco use, medical history and psychopharmacological treatment were obtained. The necessary sample size was calculated and a simple randomization was performed. Subsequently, a descriptive statistical analysis and parametric tests were conducted. RESULTS: A total of 674 patients (53% women) were evaluated, with a mean age of 78.45 years, and 27.6% of the cases (71% women) were receiving ATD. Among the 333 admitted patients (50%), 83 individuals (24.6%) had previously received ATD; this contrasts with the 103 cases (30.6%) of prior ATD treatment among the patients who were not admitted. After comparative analysis, the relationship between previous use of ATD and being admitted to hospital was not statistically significant in our global sample. This relationship was only statistically significant among the group aged 75 and over (neg. sig. 0.012). CONCLUSIONS: In our study, ATD was associated with a decreased risk of hospital admission for urgent medical conditions in people aged 75 and over. Treating depression may protect the elderly against admission to the Emergency department and may potentially be a quality criterion in preventing complications in this population.