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    標題: Anxiety and Depression in Patients with Traumatic Spinal Cord Injury: A Nationwide Population-Based Cohort Study
    作者: Lim, Sher-Wei
    Shiue, Yow-Ling
    Ho, Chung-Han
    Yu, Shou-Chun
    Kao, Pei-Hsin
    Wang, Jhi-Joung
    Kuo, Jinn-Rung
    貢獻者: Chi Mei Med Ctr, Dept Neurosurg
    Natl Sun Yat Sen Univ, Inst Biomed Sci
    Min Hwei Coll Hlth Care Management, Dept Nursing
    Chi Mei Med Ctr, Dept Med Res
    Chia Nan Univ Pharm & Sci, Dept Pharm
    Chi Mei Med Ctr, Dept Med Res
    Chi Mei Med Ctr, Dept Psychiat
    Chi Mei Med Ctr, Dept Neurosurg
    Southern Taiwan Univ Sci & Technol, Dept Biotechnol
    關鍵字: Comorbidity Index
    Global Prevalence
    Mental-Health
    Disorders
    Morbidity
    Gender
    Level
    Life
    日期: 2017-01-12
    上傳時間: 2018-11-30 15:55:31 (UTC+8)
    出版者: Public Library Science
    摘要: Background Traumatic spinal cord injury (tSCI) may involve new-onset anxiety and depression post-discharge. However, long-term population-based studies have lacked access to follow-up conditions in terms of new-onset anxiety and depression. The objective of this study was to estimate the long-term risk of new-onset anxiety and depression post-discharge. Methods The Longitudinal Health Insurance Database 2000 (LHID2000) from Taiwan's National Health Insurance Research Database was used in this study. Individuals with tSCI were identified using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnostic codes of 806 and 952 from 1999-2008. The comparison cohort (other health conditions group) was randomly selected from the LHID2000 and was 1:1 matched by age, sex, index year, and comorbidities to reduce the selection bias. All study participants were retrospectively followed for a maximum of 3 years until the end of follow-up, death, or new-onset anxiety (ICD-9-CM: 309.2-309.4) or depression (ICD-9-CM: 296.2, 296.5, 296.82, 300.4, 309.0-309.1, and 311). Persons who were issued a catastrophic illness card for tSCI were categorized as having a severe level of SCI (Injury Severity Score [ISS] >= 16). Poisson regression was used to estimate the incidence rate ratios of anxiety or depression between patients with tSCI and other health conditions. The relative risk of anxiety or depression was estimated using a Cox regression analysis, which was adjusted for potential confounding factors. Results Univariate analyses showed that the tSCI patients (n = 3556) had a 1.33 times greater incidence of new-onset anxiety or depression (95% confidence interval [CI]: 1.12-1.57) compared to the other health conditions group (n = 3556). After adjusting for potential risk factors, the tSCI patients had a significant 1.29-fold increased risk of anxiety or depression compared to the group with other health conditions (95% CI: 1.09-1.53). Individuals with tSCI, including patients who were under the age of 35, patients who were males, patients who had a low income, and patients without a Charlson Comorbidity Index score, all had a higher long-term risk of anxiety or depression than the other health conditions group (IRRs: 1.84, 1.63, 1.29, and 1.39, respectively). For all tSCI patients, those with an Injury Severity Score (ISS) >= 16 had an almost 2-fold higher risk of anxiety or depression (adjusted Hazard Ratio: 1.85; 95% CI: 1.17-2.92) compared to those with ISS < 16. Conclusions Our findings indicated that tSCI patients have a high risk of anxiety or depression post-discharge, especially among the younger tSCI patients (age < 50 years), compared with the other health conditions group. This information could help physicians understand the long-term risk of new-onset anxiety or depression in tSCI patients post-discharge.
    關聯: Plos One, v.12, n.1, e0169623
    Appears in Collections:[藥學系(所)] 期刊論文

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