#1022 Vulnerability in onconephrology: women and people who live alone are at greater risk of depression and anxiety
Bibliographic record
Abstract
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.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.007 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".