#1022 Vulnerability in onconephrology: women and people who live alone are at greater risk of depression and anxiety
Notice bibliographique
Résumé
Abstract Background and Aims Cancer is a common entity that after the new therapeutic advances is becoming chronic disease. For that reason, kidney disease prevalence is increasing in cancer patients. Consequently, Onconephrology is becoming an essential subspecialty. Psychiatric disorders are prevalent in both cancer and kidney patients. The impact of such disorders has not been studied in onconephrology patients. Our aim is to study the prevalence of psychiatric disorders in Onconephrology patients and their impact in the survival and quality of life of patients. Method This is a prospective study including all patients visited in the Onconephrology Unit in our center from November-2021 to February-2023. The following questionaries were evaluated at the first visit, 6 months and 12 months: sleep disorders (Epworth scale), depression (Geriatric Depression Scale (GDS) and Patient Questionnaire Health (PHQ)), cognition (Montreal scale) and anxiety (Generalized Anxiety Disorder (GAD). Clinical and analytical characteristics of the patients were collected. Results A total of 182 patients were included, mean age 68 (±11) years, 70 (38.5%) women, 56 (30.8%) diabetes mellitus, mean creatinine 1.7 (±0.88) mg/dL, and glomerular filtration rate (GFR) 44 (±21) ml/min. A total of 18 (9.9%) patients lived alone, 152 (83.5%) lived accompanied and 4 (2.2%) in residence. The most common neoplasm was lung (n = 38; 20.9%) and the reason for referral to Onconephrology was chronic kidney disease (n = 94; 51.6%). At the first visit, 81 patients (44.5%) had sleep disorder, 32.7% (n = 59) had depression, 72 (39.6%) had cognitive impairment and 14 (7.7%) had anxiety. In the univariate analysis we evidenced that patients who lived in residence presented more prevalence of depression (p = 0.013). Patients with cognitive impairment had a higher prevalence of DM (p = 0.003), worse kidney function and were older (p < 0.001). Patients who had sleep disorders were older (p = 0.01) and women had more prevalence of anxiety (p < 0.001). At six months of follow-up, women presented anxiety with more prevalence (p = 0.03) as well as those who presented oncological progressive disease (p < 0.001). Patients who lived alone presented more depression compared to patients lived accompanied (p = 0.002). At twelve months of follow-up, oncological progression was associated with depression (p = 0.034). In the multivariate analysis, age was identified as a risk factor for cognitive impairment (OR: 1.1; p < 0.001) and female sex for depression (OR: 3.39; p = 0.001). At 6 months of follow-up woman sex for anxiety disorder (OR:8.6;p = 0.01) and patients who lived alone were identified as risk factors for depression (OR: 10.8; p < 0.001). A total of 30 patients (16.5%) died during the follow-up. In the Kaplan-Meier analysis, more mortality was observed in patients with sleep disorders (p = 0.039), worse kidney function (p = 0.003) and oncological progressive disease (p = 0.028). These were not confirmed in multivariate analysis Conclusion Onconephrology patients had a high prevalence of depression and anxiety, especially female and patients who live alone. Therefore, it is essential to perform a comprehensive approach and to have tools to detect the vulnerable population to improve their survival and quality of life.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,007 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».