Abstract
BACKGROUND: Anxiety and depression are prevalent among elderly inpatients and may significantly influence clinical outcomes, particularly in patients with chronic diseases. However, limited research has explored these psychological conditions in elderly patients with digestive system diseases in the Southwest China region. OBJECTIVE: This study aimed to evaluate the associations between depression symptoms and clinical outcomes in elderly inpatients with digestive system diseases in Southwest China. Anxiety symptoms were examined as an associated variable and further analyzed in exploratory subgroup assessments. METHODS: A retrospective cohort study was conducted using data from 1,290 elderly inpatients aged 60 years or older hospitalized with a primary diagnosis of digestive system disease between January 2018 and December 2022 at a tertiary care hospital in Southwest China. Anxiety and depression symptoms were assessed using the Hospital Anxiety and Depression Scale (HADS), with a score ≥ 8 indicating clinically relevant symptoms. Clinical outcomes included prolonged hospital stay (≥ 14 days), hospitalization costs, complications during hospitalization, 30-day readmission, and in-hospital mortality. Multivariable logistic regression models were used to examine the associations, and subgroup analyses stratified by gender and age were performed. RESULTS: Anxiety symptoms were observed in 33.2% of patients, while 37.4% exhibited depression symptoms. Depression was significantly associated with longer hospital stays (14.2 ± 6.3 vs. 11.3 ± 5.2 days, P < 0.001), higher hospitalization costs (¥12,300 vs. ¥10,800, P < 0.001), and increased complication rates, including infections (29.5% vs. 20.8%, P < 0.001) and gastrointestinal bleeding (19.1% vs. 11.6%, P < 0.001). Subgroup analyses revealed that anxiety symptoms were strongly associated with prolonged hospital stays, particularly among female patients aged ≥ 70 years (adjusted OR: 2.35, 95% CI: 1.68-3.30, P < 0.001). Multivariable analysis identified poor sleep quality, cognitive impairment, and digestive system tumors as variables independently associated with anxiety symptoms. CONCLUSION: Anxiety and depression symptoms are prevalent among elderly inpatients with digestive system diseases in Southwest China and are associated with adverse clinical outcomes, including prolonged hospital stay, increased healthcare costs, and higher complication rates. Female patients and those aged ≥ 70 years are particularly vulnerable. Early psychological assessment and targeted interventions may improve clinical outcomes in this population.