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To explore the association between depressive symptoms and all-cause mortality and cardiovascular disease mortality in patients with chronic comorbidity.
Single-factor analysis was performed using chi-square test, and the relationship between PHQ-9 scores, depressive symptoms, and all-cause mortality as well as cardiovascular disease mortality in patients of multimorbidity were analyzed using COX proportional hazards regression model.
The results of the multivariable COX regression showed that as compared to those without depressive symptoms, patients of multimorbidity with depressive symptoms had HR=1.665 (95% CI: 1.135-2.444) for all-cause mortality and HR=2.090 (95% CI: 1.216-3.594) for cardiovascular mortality. With an increase in PHQ-9 score, the risks of all-cause mortality (HR=1.060, 95% CI: 1.014-1.107) (Ptrend<0.010) and cardiovascular mortality (HR=1.072, 95% CI: 1.005-1.144) (Ptrend<0.010) gradually increased. Subgroup analysis by urban and rural areas showed that there was an interaction between different urban and rural depressive symptoms on the risk of all-cause mortality in patients of multimorbidity (P interaction <0.05). In rural areas, patients of multimorbidity with depressive symptoms had 2.637 times (95% CI: 1.639-4.243) higher risk of all-cause mortality and 3.207 times (95% CI: 1.686-6.101) higher risk of cardiovascular mortality compared to those without depressive symptoms. With an increase in PHQ-9 score, the risks of all-cause mortality (Ptrend<0.001) and cardiovascular mortality (Ptrend<0.001) also increased. However, these associations were not significant in urban areas.
Depressive symptoms is a risk factor for all-cause mortality and cardiovascular disease mortality in patients of multimorbidity, and more attention should be paid to psychological interventions for patients of multimorbidity in rural areas to reduce the risk of mortality in patients of multimorbidity.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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