Antecedentes y presencia de trastornos depresivos como factor de riesgo de ingreso hospitalario en pacientes mayores de 74 años atendidos en un servicio de urgencias / Current and lifetime depression as a risk factor for hospital admission in patients older than 74 years attended in an emergency department

IntroducciónLos trastornos depresivos son especialmente frecuentes en la persona mayor. Además de reducir su calidad de vida, pueden incidir en determinados aspectos de la evolución de sus enfermedades médicas. El objetivo es analizar si los trastornos depresivos en la persona mayor que acude a urgencias por una causa médica constituyen un factor de riesgo de ingreso hospitalario.Material y métodosSe incluyen personas mayores de 74 años que acudieron al Servicio de Urgencias del Hospital Universitario Central de Asturias (2004–2005) y que requirieron de una valoración geriátrica integral. Se obtuvieron datos sociodemográficos, estado funcional previo, situación cognitiva y presencia de trastornos depresivos. Se realizó un análisis de regresión logística.ResultadosSe valoraron 1.016 pacientes (el 62,32% eran mujeres), con una edad media de 87,4 años. Índice de Barthel medio previo de 71,8 (intervalo de confianza [IC] del 95%: 69,8–73,9). Diagnosticados como trastorno depresivo en el 17,4% de los casos (el 75,7% eran mujeres). Del total, ingresaron 721 individuos (71,0%), mientras que entre los diagnosticados de depresión, ingresó el 79,7% (p=0,002). Tras el análisis de regresión logística ajustado por edad, sexo, estado civil, institucionalización, forma de convivencia, índice de Barthel y deterioro cognitivo, la depresión se asoció de forma independiente a un mayor riesgo de ingreso (odds ratio: 1,83; IC del 95%: 1,20–2,78).ConclusionesLas personas mayores de 74 años que acuden a un servicio de urgencias, realizándose una valoración geriátrica integral y que presentan sintomatología depresiva, tienen un mayor riesgo de ingreso hospitalario(AU)

IntroductionDepression is especially frequent in the elderly. In addition to impairing quality of life, this disorder can affect the outcome of medical diseases. The objective is to analyze whether depressive disorders in elderly individuals attending an emergency room for medical complaints constitute a risk factor for admission.Material and methodsAll patients aged more than 74 years old attending the Emergency Department of the Hospital Universitario Central de Asturias who required comprehensive geriatric assessment from 2004 to 2005 were included in this study. Sociodemographic variables and data on functional, cognitive and emotional status before attendance at the emergency department were collected. A logistic regression analysis was performed to determine whether there was an independent association between depression and admission to the Geriatric Service.ResultsA total of 1016 patients (62.32% women) were evaluated. The mean age was 87.4 years. The Barthel index before admission to the emergency department was 71.8 (95% confidence interval [CI]: Depression was diagnosed in 17.4% of the patients (75.7% women). Of the whole sample, 721 patients (71.0%) were admitted to a geriatric service, while 79.7% of patients with depression were admitted (p=0.002). After multivariate regression analysis adjusted by age, sex, marital status, institutionalization, living arrangements, Barthel index and cognitive status before admission, depression was independently associated with a greater risk for admission to a geriatric service (odds ratio: 1.83, 95% CI: 1.20–2.78).ConclusionsDepression and mood disorders constitute an independent risk factor for admission to a geriatric service in patients aged more than 74 years assessed by comprehensive geriatric methodology in an emergency department(AU)

[Current and lifetime depression as a risk factor for hospital admission in patients older than 74 years attended in an emergency department]. / Antecedentes y presencia de trastornos depresivos como factor de riesgo de ingreso hospitalario en pacientes mayores de 74 años atendidos en un servicio de urgencias.

INTRODUCTION: Depression is especially frequent in the elderly. In addition to impairing quality of life, this disorder can affect the outcome of medical diseases. The objective is to analyze whether depressive disorders in elderly individuals attending an emergency room for medical complaints constitute a risk factor for admission. MATERIAL AND METHODS: All patients aged more than 74 years old attending the Emergency Department of the Hospital Universitario Central de Asturias who required comprehensive geriatric assessment from 2004 to 2005 were included in this study. Sociodemographic variables and data on functional, cognitive and emotional status before attendance at the emergency department were collected. A logistic regression analysis was performed to determine whether there was an independent association between depression and admission to the Geriatric Service. RESULTS: A total of 1016 patients (62.32% women) were evaluated. The mean age was 87.4 years. The Barthel index before admission to the emergency department was 71.8 (95% confidence interval [CI]: Depression was diagnosed in 17.4% of the patients (75.7% women). Of the whole sample, 721 patients (71.0%) were admitted to a geriatric service, while 79.7% of patients with depression were admitted (p=0.002). After multivariate regression analysis adjusted by age, sex, marital status, institutionalization, living arrangements, Barthel index and cognitive status before admission, depression was independently associated with a greater risk for admission to a geriatric service (odds ratio: 1.83, 95% CI: 1.20-2.78). CONCLUSIONS: Depression and mood disorders constitute an independent risk factor for admission to a geriatric service in patients aged more than 74 years assessed by comprehensive geriatric methodology in an emergency department.