TY - JOUR
T1 - Two-step screening for depressive symptoms and prediction of mortality in patients with heart failure
AU - Lee, Kyoung Suk
AU - Moser, Debra K.
AU - Pelter, Michele
AU - Biddle, Martha J.
AU - Dracup, Kathleen
N1 - Publisher Copyright:
© 2017 American Association of Critical-Care Nurses.
PY - 2017/5/1
Y1 - 2017/5/1
N2 - Background Comorbid depression in patients with heart failure is associated with increased risk for death. In order to effectively identify depressed patients with cardiac disease, the American Heart Association suggests a 2-step screening method: administering the 2-item Patient Health Questionnaire first and then the 9-item Patient Health Questionnaire. However, whether the 2-step method is better for predicting poor prognosis in heart failure than is either the 2-item or the 9-item tool alone is not known. Objective To determine whether the 2-step method is better than either the 2-item or the 9-item questionnaire alone for predicting all-cause mortality in heart failure. Methods During a 2-year period, 562 patients with heart failure were assessed for depression by using the 2-step method. With the 2-step method, results are considered positive if patients endorse either depressed mood or anhedonia on the 2-item screen and have scores of 10 or higher on the 9-item screen. Results Screening results with the 2-step method were not associated with all-cause mortality. Patients with scores positive for depression on either the 2-item or 9-item screen alone had 53% and 60% greater risk, respectively, for all-cause death than did patients with scores negative for depression after adjustments for covariates (hazard ratio, 1.530; 95% CI, 1.029-2.274 for the 2-item screen; hazard ratio, 1.603; 95% CI, 1.079- 2.383 for the 9-item screen). Conclusions The 2-step method has no clear advantages compared with the 2-item screen alone or the 9-item screen alone for predicting adverse prognostic effects of depressive symptoms in heart failure.
AB - Background Comorbid depression in patients with heart failure is associated with increased risk for death. In order to effectively identify depressed patients with cardiac disease, the American Heart Association suggests a 2-step screening method: administering the 2-item Patient Health Questionnaire first and then the 9-item Patient Health Questionnaire. However, whether the 2-step method is better for predicting poor prognosis in heart failure than is either the 2-item or the 9-item tool alone is not known. Objective To determine whether the 2-step method is better than either the 2-item or the 9-item questionnaire alone for predicting all-cause mortality in heart failure. Methods During a 2-year period, 562 patients with heart failure were assessed for depression by using the 2-step method. With the 2-step method, results are considered positive if patients endorse either depressed mood or anhedonia on the 2-item screen and have scores of 10 or higher on the 9-item screen. Results Screening results with the 2-step method were not associated with all-cause mortality. Patients with scores positive for depression on either the 2-item or 9-item screen alone had 53% and 60% greater risk, respectively, for all-cause death than did patients with scores negative for depression after adjustments for covariates (hazard ratio, 1.530; 95% CI, 1.029-2.274 for the 2-item screen; hazard ratio, 1.603; 95% CI, 1.079- 2.383 for the 9-item screen). Conclusions The 2-step method has no clear advantages compared with the 2-item screen alone or the 9-item screen alone for predicting adverse prognostic effects of depressive symptoms in heart failure.
UR - http://www.scopus.com/inward/record.url?scp=85028945873&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85028945873&partnerID=8YFLogxK
U2 - 10.4037/ajcc2017325
DO - 10.4037/ajcc2017325
M3 - Article
C2 - 28461546
AN - SCOPUS:85028945873
SN - 1062-3264
VL - 26
SP - 240
EP - 247
JO - American Journal of Critical Care
JF - American Journal of Critical Care
IS - 3
ER -