Data_Sheet_1_Prevalence of depression and its potential contributing factors in patients with enterostomy: A meta-analytical review.docx

ObjectiveIn patients with intestinal pathologies, the placement of a stoma bag affects multiple aspects of their perceived quality of life. This meta-analysis aims to evaluate the prevalence of depression among patients with enterostomy and to determine the underlying factors that could explain the potential heterogeneity of this prevalence.
MethodsRelevant published studies were identified by searching PubMed, Embase, PsycINFO, Cochrane, CINAHL, Scopus, and Web of Science until May 2022. The random-effects model was used to determine the pooled prevalence of depression among patients with enterostomy using cross-sectional studies from various countries. Meta-regression and subgroup analysis were performed to identify factors contributing to heterogeneity. Quality assessment of the included studies was conducted using the Newcastle-Ottawa scale for nonrandomized studies.
ResultsThe pooled prevalence of depressive symptoms among patients with enterostomy, as calculated using the random-effects model, was 41.6% (95% confidence interval [CI]: 25.4–59.7%, Q-value = 145.794, df = 8, p < 0.001, tau∧2 = 1.124, I∧2 = 94.513). The meta-regression found that mean age and gender were not significant moderators for the observed heterogeneity in prevalence. Subgroup analysis according to the indications for enterostomy formation showed that the prevalence of depression was highest in patients with colorectal cancer, at 34.4% (95% CI: 27.2–42.4%). Subgroup analysis by region showed that patients in Africa had the highest prevalence of depression, at 88.2% (95% CI: 76.1–94.6%), compared to other regions. Subgroup analysis by stoma indication was not significant.
ConclusionThis meta-analysis reports that the pooled prevalence of depression among patients with enterostomy is 41.6%. Indications for enterostomy formation, as well as geographical region, were identified as potential sources of heterogeneity. These findings highlight the need for appropriate psychosocial support and interventions at different stages of enterostomy placement.

Objective：肠道疾病患者接受造口袋（stoma bag）安置术后，其主观感知的生活质量多个维度均会受到影响。本项元分析旨在评估肠造口术（enterostomy）患者的抑郁症患病率，并阐明可能解释该患病率存在异质性的潜在影响因素。
Methods：本研究通过检索PubMed、Embase、PsycINFO、Cochrane、CINAHL、Scopus及Web of Science数据库，截至2022年5月筛选获得相关已发表研究。采用随机效应模型（random-effects model），对来自多国的横断面研究数据进行合并分析，以计算肠造口术患者的抑郁症合并患病率。通过元回归（meta-regression）与亚组分析，明确导致异质性的相关因素。采用纽卡斯尔-渥太华量表（Newcastle-Ottawa Scale）对纳入的非随机研究进行质量评价。
Results：经随机效应模型计算，肠造口术患者的抑郁症状合并患病率为41.6%（95%置信区间[CI]：25.4%~59.7%，Q值=145.794，自由度df=8，p<0.001，τ²=1.124，I²=94.513）。元回归分析结果显示，平均年龄与性别并非该患病率异质性的显著调节因素。按肠造口术适应证开展的亚组分析显示，结直肠癌患者的抑郁症患病率最高，达34.4%（95%CI：27.2%~42.4%）。按地域划分的亚组分析显示，与其他地区相比，非洲患者的抑郁症患病率最高，达88.2%（95%CI：76.1%~94.6%）。按造口适应证进行的亚组分析未发现显著差异。
Conclusion：本项元分析结果显示，肠造口术患者的抑郁症合并患病率为41.6%。肠造口术适应证与地理区域被确认为该患病率异质性的潜在来源。本研究结果提示，需在肠造口术安置的不同阶段为患者提供适宜的社会心理支持与干预方案。