双相障碍抑郁发作患者急性期治疗有效后3年的再入院率及影响因素分析

Rehospitalization rates and influencing factors of patients with bipolar disorder after effective treatment in the acute phase of depressive episodes within 3 years

目的分析双相障碍抑郁发作患者急性期治疗有效后3年的再入院率及影响因素。方法采用便利抽样法,选取2015年9月至2018年9月在首都医科大学附属北京安定医院住院且急性期治疗有效的315例双相障碍抑郁发作患者为研究对象。收集患者的人口学资料、病史、临床特征等资料。随访3年,追踪再入院情况,采用Cox比例风险模型分析双相障碍抑郁发作患者急性期治疗有效后3年再入院的影响因素。结果共289例患者完成随访,其中39.45%(114/289)的患者治疗后3年内再次入院。多因素Cox回归分析结果显示,总发作次数多是患者治疗后3年再入院的危险因素(HR=1.081,95%CI:1.040~1.124,P<0.01),基线治疗方式为心境稳定剂/抗精神病药是患者治疗后3年再入院的保护因素(HR=0.471,95%CI:0.321~0.692,P<0.01)。结论发作次数多、急性期使用心境稳定剂/抗精神病药物联合抗抑郁药治疗是双相障碍抑郁发作患者急性期治疗有效后3年内再入院的危险因素,临床需给予足够的重视并进行相应的干预。

Objective To analyze the rehospitalization rate and influencing factors of patients with bipolar depressive episode after effective treatment in acute phase for 3 years.Methods A total of 315 patients with bipolar depression during acute phase,who were hospitalized and received effective treatment in Beijing Anding Hospital of Capital Medical University from September 2015 to September 2018,were recruited as research objects by convenience sampling method.Demographic information,medical history,clinical features and other data of patients were collected.The patients were followed up for 3 years,and their rehospitalization conditions were tracked.The Cox proportional risk model was used to analyze the influencing factors of rehospitalization of patients with bipolar depressive episode after effective treatment in acute phase for 3 years.Results A total of 289 patients completed follow-up,and 39.45%(114/289) of them were readmitted to hospital within 3 years.Multivariate Cox regression analysis showed that the total number of attacks was a risk factor for readmission 3 years after treatment(HR=1.081,95%CI:1.040-1.124,P<0.01),and the baseline treatment of mood stabilizers/antipsychotic was a protective factor for readmission 3 years after treatment(HR=0.471,95%CI:0.321-0.692,P<0.01).Conclusions Multiple episodes,mood stabilizers/antipsychotics combined with antidepressant in the acute phase are the risk factors for patients with bipolar disorder to be readmitted within 3 years after effective treatment in the acute phase.Clinical attention should be paid enough and corresponding intervention should be carried out.