探討憂鬱對冠心病患不良預後的影響：系統性文獻回顧

An Exploration into the Impact of Depression on Poor Prognosis in Patients with Coronary Heart Diseases(CHDs): A Systematic Review

何崇萍(Chung-Ping He) ； 蘇淑芬(Shu-Fen Su)

《弘光學報》 78期 (2016/09) Pp. 47-63

https://doi.org/10.6615/HAR.201609.78.05

摘要

背景：冠心病是造成全球人類失能、死亡的頭號殺手，對國家經濟造成沉重負擔，易誘發患者陷入憂鬱症，所帶來的負面影響甚鉅，但缺乏系統性文獻查證深入分析及驗證。目的：探討憂鬱對冠心病患者不良預後的影響。方法：以關鍵字搜尋近二十年Cochrane、PubMed、Medline、CINAHL、ProQuest、臺灣期刊論文、全國碩博士論文資料庫、華藝中文及Google scholar等中、英資料庫，以PECO（Patient, Exposure, Comparison, Outcome）建立中、英文關鍵字，P：冠心病，E：憂鬱症，C：無憂鬱症，O：不良預後，選取與主題相關之世代研究，以CASP(Critical Appraisal Skills Programme)為研究評析工具。結果：共納入19篇研究34,106位冠心病患者的分析結果指出，陷入憂鬱症顯著影響患者不良預後，造成患者再住院率提高，心臟事件發生率增加及總死亡率風險上升。結論：所有納入的研究均來自西方歐美國家，多為非隨機控制之研究設計且各篇世代追蹤年限不同，結果難以推論東方國家及華人，建議未來可推動嚴謹、大規模的跨國世代研究，建置及收集本土化相關資料，以驗證東西方實證結果。

關鍵字

冠心病 ； 憂鬱 ； 不良預後 ； 系統性文獻回顧

並列摘要

Background：Coronary heart disease(CHD) is the top one killer which globally causes human disability and death, resulting in heavy economic burden for the countries. It can easily induce patients into depressive disorder and bring huge negative impact. However, there is a lack of systematic literature to deeply analysis and verify the correlation between both. Purpose：Explore the impact of depression on poor prognosis in patients with CHD. Methods：This review focused on Chinese and English studies published within 20 years in the database of Cochrane、PubMed、Medline、CINAHL、ProQuest、National Digital Library of Theses and Dissertations in Taiwan、Airiti Library, and Google scholar using relevant keywords. Keywords used referenced the PECO format, P:coronary heart disease, E:depressive disorder, C:non- depressive disorder, O: poor prognosis. Cohort studies were included in this review. The Critical Appraisal Skills Programme(CASP)was used to appraise the quality of the reviewed studies. Results：19 cohort studies were enrolled with a total of 34,106 CHD patients were included in this systematic review. Results showed that depression significantly affected poor prognosis of CHD patients, resulting in higher re-admission rate, cardiac events, and all-causes mortality. Conclusion：All studies reviewed in this study were from European and North American countries, and most of them were nonrandomized control trials with different tracking years. Thus, these findings were limited in terms of generalizability to Eastern countries and the Chinese. We suggest that a rigorous with large-scale multinational cohort study is needed to help in building the localization of relevant information and verify the empirical results of East and West countries.

並列關鍵字

coronary heart disease ； depression ； poor prognosis ； systematic review

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