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. 2013 Apr;103(4):e130-7.
doi: 10.2105/AJPH.2012.301146. Epub 2013 Feb 14.

Association of posttraumatic stress disorder and depression with all-cause and cardiovascular disease mortality and hospitalization among Hurricane Katrina survivors with end-stage renal disease

Donald Edmondson  1 , Christopher Gamboa, Andrew Cohen, Amanda H Anderson, Nancy Kutner, Ian Kronish, Mary A Mills, Paul Muntner
Affiliations

Association of posttraumatic stress disorder and depression with all-cause and cardiovascular disease mortality and hospitalization among Hurricane Katrina survivors with end-stage renal disease

Donald Edmondson et al. Am J Public Health. 2013 Apr.

Abstract

Objectives: We determined the association of psychiatric symptoms in the year after Hurricane Katrina with subsequent hospitalization and mortality in end-stage renal disease (ESRD) patients.

Methods: A prospective cohort of ESRD patients (n = 391) treated at 9 hemodialysis centers in the New Orleans, Louisiana, area in the weeks before Hurricane Katrina were assessed for posttraumatic stress disorder (PTSD) and depression symptoms via telephone interview 9 to 15 months later. Two combined outcomes through August 2009 (maximum 3.5-year follow-up) were analyzed: (1) all-cause and (2) cardiovascular-related hospitalization and mortality.

Results: Twenty-four percent of participants screened positive for PTSD and 46% for depression; 158 participants died (79 cardiovascular deaths), and 280 participants were hospitalized (167 for cardiovascular-related causes). Positive depression screening was associated with 33% higher risk of all-cause (hazard ratio [HR] = 1.33; 95% confidence interval [CI] = 1.06, 1.66) and cardiovascular-related hospitalization and mortality (HR = 1.33; 95% CI = 1.01, 1.76). PTSD was not significantly associated with either outcome.

Conclusions: Depression in the year after Hurricane Katrina was associated with increased risk of hospitalization and mortality in ESRD patients, underscoring the long-term consequences of natural disasters for vulnerable populations.

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Figures

FIGURE 1—
FIGURE 1—
Cumulative incidence curves for posttraumatic stress disorder (PTSD) status and hospitalization or death from (a) all causes and (b) cardiovascular disease: New Orleans, LA, 2006–2009. Note. Log-rank test P = .23 for all causes and P = .21 for cardiovascular disease.
FIGURE 2—
FIGURE 2—
Cumulative incidence curves for depression status and hospitalization or death from (a) all causes and (b) cardiovascular disease: New Orleans, LA, 2006–2009. Note. Log-rank test P = .21 for all causes and P = .01 for cardiovascular disease.
See this image and copyright information in PMC

References

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