Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Jan;355(1):21-26.
doi: 10.1016/j.amjms.2017.08.015. Epub 2017 Nov 20.

The Association Between Major Depressive Disorder and Outcomes in Older Veterans Hospitalized With Pneumonia

Ami L DeWaters  1 , Matthieu Chansard  1 , Antonio Anzueto  2 , Mary Jo Pugh  2 , Eric M Mortensen  3
Affiliations

The Association Between Major Depressive Disorder and Outcomes in Older Veterans Hospitalized With Pneumonia

Ami L DeWaters et al. Am J Med Sci. 2018 Jan.

Abstract

Background: Major depressive disorder ("depression") has been identified as an independent risk factor for mortality for many comorbid conditions, including heart failure, cancer and stroke. Major depressive disorder has also been linked to immune suppression by generating a chronic inflammatory state. However, the association between major depression and pneumonia has not been examined. The aim of this study was to examine the association between depression and outcomes, including mortality and intensive care unit admission, in Veterans hospitalized with pneumonia.

Materials and methods: We conducted a retrospective national study using administrative data of patients hospitalized at any Veterans Administration acute care hospital. We included patients ≥65 years old hospitalized with pneumonia from 2002-2012. Depressed patients were further analyzed based on whether they were receiving medications to treat depression. We used generalized linear mixed effect models to examine the association of depression with the outcomes of interest after controlling for potential confounders.

Results: Patients with depression had a significantly higher 90-day mortality (odds ratio 1.12, 95% confidence interval 1.07-1.17) compared to patients without depression. Patients with untreated depression had a significantly higher 30-day (1.11, 1.04-1.20) and 90-day (1.20, 1.13-1.28) mortality, as well as significantly higher intensive care unit admission rates (1.12, 1.03-1.21), compared to patients with treated depression.

Conclusion: For older veterans hospitalized with pneumonia, a concurrent diagnosis of major depressive disorder, and especially untreated depression, was associated with higher mortality. This highlights that untreated major depressive disorder is an independent risk factor for mortality for patients with pneumonia.

Keywords: Major depressive disorder; Mortality; Pneumonia.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: All authors who contributed to this study had no conflicts of interest to report.

Figures

Figure 1
Figure 1
Kaplan-Meier graph of depression versus no depression
Figure 2
Figure 2
Kaplan-Meier graph of treated versus untreated depression
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Kessler RC, Berglund P, Demler O, et al. The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R) Jama. 2003;289:3095–105. - PubMed
    1. Ambulatory Care Use and Physician office visits. 2016. [Accessed November 1st, 2016].
    1. Barth J, Schumacher M, Herrmann-Lingen C. Depression as a risk factor for mortality in patients with coronary heart disease: a meta-analysis. Psychosomatic medicine. 2004;66:802–13. - PubMed
    1. Jiang W, Alexander J, Christopher E, et al. Relationship of depression to increased risk of mortality and rehospitalization in patients with congestive heart failure. Arch Intern Med. 2001;161:1849–56. - PubMed
    1. Satin JR, Linden W, Phillips MJ. Depression as a predictor of disease progression and mortality in cancer patients. Cancer. 2009;115:5349–61. - PubMed

Publication types

MeSH terms