Trend of depression and its association with sociodemographic and clinical factors among multiple myeloma hospitalizations: A Portuguese nationwide study from 2000 to 2015

Abstract

Objective: Patients hospitalized with multiple myeloma (MM) are particularly vulnerable to depression. The present study aims to determine the frequency of depression among MM hospitalized patients, in order to assess the possible differences between those with and without depression in relation to sociodemographic and clinical variables and to measure the impact of depression on hospitalization outcomes. Methods: An observational retrospective study was performed using an administrative data set of all hospitalizations with a primary diagnosis of MM between 2000 and 2015 in Portuguese mainland public hospitals. Codes related to depressive disorders were grouped to generate the dichotomous variable of depression (yes/no). A multivariate analysis was conducted and adjusted odd ratios (aOR) calculated between different variables and depression. Results: Of a total of 14.575 MM hospitalizations studied, a concurrent code of depression was registered in 666 patients (4.6%). A greater odds of depression was observed in female patients (aOR = 2.26; 95%CI = 1.91-2.66), transplanted patients (aOR = 1.78; 95%CI = 1.44-2.20), patients with plasma cell leukemia (aOR = 1.79; 95%CI = 1.22-2.64) and patients with a higher Charlson Comorbidity Index (CCI) (aOR = 1.10; 95%CI = 1.05-1.15). Length of stay was longer in patients with a registered diagnosis of depression (aOR = 1.01; 95%CI = 1.01-1.02) while the odds of inhospital mortality were lower in these patients (aOR = 0.53; 95%CI = 0.41-0.68). Conclusions: These results may help identify MM inpatients at higher risk of presenting depression (female gender, younger age, high CCI, plasma cell leukemia, transplant procedure). This will enable timely psychological assessment and treatment to prevent worse outcomes and higher healthcare costs associated with depression.

Disparities in Outcomes of Hospitalizations Due to Multiple Myeloma: A Nationwide Comparison

“…In our study, obese MM patients did not have a statistically increased risk of mortality; this is in contradiction to a previous meta-analysis that noted that obesity is associated with a higher relative risk of death [36]. A large Portuguese study has shown the odds of in-hospital mortality are lower in depressed patients, but the length of hospital stay is longer [37]. Similarly, in real-world data, overall survival from chronic obstructive pulmonary disease (COPD) in multiple myeloma is worse, which contradicts our finding of a low odds ratio of mortality in hospitalized patients [38,39].…”

Pain as a risk factor of depression and anxiety symptoms with multiple myeloma during maintenance therapy

“…To date, only a few studies have assessed the depressive and anxious states of MM patients in the early survivorship period ( Ribeiro-Carvalho et al, 2020 ; Zaleta et al, 2020 ). Practitioners generally believe that the anxiety and depression should be eased after maintenance therapy.…”