Dataset Information

Depression amongst patients commencing maintenance dialysis is associated with increased risk of death and severe infections: A nationwide cohort study.

ABSTRACT:

Background

Depression is common in dialysis patients, but the clinical impact of this condition is poorly defined.

Methods

Out of 57,703 patients starting dialysis during 2000-2007 recorded in the National Health Insurance Research Database of Taiwan, we identified 2,475 patients with a clinical diagnosis of depression, and compared them with 1:5 age- and sex-matched patients without a depression diagnosis (n = 12,375). Patients were followed up for hospitalisation due to severe infections, major adverse cardiovascular events (MACE) and death. Multivariable Cox regression and competing risk analyses (accounting for death when appropriate) were used to estimate risk associations.

Results

Patients with depression had a higher frequency of comorbidities. During a mean follow-up of 3.2 years, 1,140 severe infections, 806 MACE, and 1,121 deaths were recorded. Compared to controls, patients with depression were at increased risk of death (adjusted hazard ratio 1.24; 95%CI 1.16-1.33). Patients with depression were also at higher risk of severe (1.14; 1.06-1.22) and fatal infections (death within 30 days, 1.22; 1.09-1.35), attributed mainly to sepsis (1.19; 1.08-1.31), septic shock (1.36; 1.13-1.62) and pneumonia (1.19; 1.07-1.33). Conversely, no association was observed between depression and the MACE risk (1.04; 0.94-1.15).

Conclusion

Dialysis patients with depression are associated with increased risk of infections and death.

SUBMITTER: Wu PH

PROVIDER: S-EPMC6564035 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Publications

Depression amongst patients commencing maintenance dialysis is associated with increased risk of death and severe infections: A nationwide cohort study.

Wu Ping-Hsun PH Lin Ming-Yen MY Huang Teng-Hui TH Lin Yi-Ting YT Hung Chi-Chih CC Yeh Yi-Chun YC Kuo Hung-Tien HT Chiu Yi-Wen YW Hwang Shang-Jyh SJ Tsai Jer-Chia JC Carrero Juan-Jesus JJ

PloS one 20190613 6

<h4>Background</h4>Depression is common in dialysis patients, but the clinical impact of this condition is poorly defined.<h4>Methods</h4>Out of 57,703 patients starting dialysis during 2000-2007 recorded in the National Health Insurance Research Database of Taiwan, we identified 2,475 patients with a clinical diagnosis of depression, and compared them with 1:5 age- and sex-matched patients without a depression diagnosis (n = 12,375). Patients were followed up for hospitalisation due to severe i ...[more]

PMID: 31194838

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Project description:BackgroundThe role of bacterial and viral co-infection in the current COVID-19 pandemic remains elusive. The aim of this study was to describe the rates and features of co-infection on admission of COVID-19 patients, based on molecular and routine laboratory methods.MethodsA retrospective study of COVID-19 and non-COVID-19 patients undergoing Biofire®, FilmArray® Pneumonia Panel, bioMérieux, and routine cultures during the first 3 days from admission, between June 2019 and March 2021.ResultsFilmArray tests were performed in 115 COVID-19 and in 61 non-COVID-19 patients. Most (>99%) COVID-19 patients had moderate-critical illness, 37% required mechanical ventilation. Sputa and endotracheal aspirates were the main samples analyzed. Positive FilmArray tests were found in 60% (70/116) of the tests amongst COVID-19 patients and 62.5% (40/64) amongst non-COVID-19 patients. All 70 cases were positive for bacterial targets, while one concomitant virus (Rhinovirus/Enterovirus) and one Legionella spp. were detected. The most common bacterial targets were Haemophilus influenzae (36%), Staphylococcus aureus (23%), Streptococcus pneumoniae (10%) and Enterobacter cloacae (10%). Correlation between FilmArray and cultures was found in 81% and 44% of negative and positive FA tests, respectively. Positive FilmArray results typically (81%) triggered the administration of antibiotic therapy and negative results resulted in antimicrobials to be withheld in 56% of cases and stopped in 8%. Bacterial cultures of COVID-19 patients were positive in 30/88 (34%) of cases.ConclusionsBacterial co-infection is common amongst moderate-critical COVID-19 patients on admission while viral and atypical bacteria were exceedingly rare. Positive FilmArray results could trigger potentially unnecessary antibiotic treatment.KEY POINTWe found high rates of on-admission bacterial co-infection amongst hospitalized moderate to severe COVID-19 patients. Molecular tests (Biofire, FilmArray) and routine microbiological tests revealed 60% and 34% bacterial co-infection, respectively, while viral and fungal co-infections were rare.

Dataset Information

Depression amongst patients commencing maintenance dialysis is associated with increased risk of death and severe infections: A nationwide cohort study.

Background

Methods

Results

Conclusion

Publications

Depression amongst patients commencing maintenance dialysis is associated with increased risk of death and severe infections: A nationwide cohort study.

Similar Datasets

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