Naess H, Lunde L, Brogger J, Waje-Andreassen U
Department of Neurology, Haukeland University Hospital, Bergen, Norway.
Acta Neurol Scand Suppl. 2010(190):34-8. doi: 10.1111/j.1600-0404.2010.01373.x.
To assess the influence of depression prior to stroke (PD) on stroke severity on admittance, functional outcome (short- and long-term), mortality, and long-term depression (PSD).
Consecutive acute stroke patients were screened for PD. The National Institute of Health Stroke Scale score was obtained on admission. Short-term functional state was registered by the modified Rankin scale and on long-term functional outcome by the Barthel Index. PSD was defined as depression subscale of the hospital anxiety and depression scale (HADSD) >or=11. HADSD and Barthel Index were obtained by postal questionnaire. Survival analyses were performed.
Among 771 patients 21.7% had PD. Among 376 patients returning the questionnaire, 8.8% were depressed. On logistic regression analyses severity of stroke on admission, short-term, and long-term functional outcome were independently associated with PD. Logistic regression showed PSD to be independently associated with PD and being unmarried. Cox regression analyses showed that both PD and PSD were associated with high long-term mortality.
This study has identified several factors associated with PSD. PD predicts more severe stroke on admittance and less functional improvement both in the short- and the long-term. Both PD and PSD predict higher long-term mortality.
评估卒中前抑郁（PD）对入院时卒中严重程度、功能结局（短期和长期）、死亡率及长期抑郁（PSD）的影响。
对连续的急性卒中患者进行PD筛查。入院时获取美国国立卫生研究院卒中量表评分。短期功能状态通过改良Rankin量表记录，长期功能结局通过Barthel指数记录。PSD定义为医院焦虑抑郁量表（HADSD）抑郁分量表得分≥11分。通过邮寄问卷获取HADSD和Barthel指数。进行生存分析。
771例患者中21.7%有PD。在376例回复问卷的患者中，8.8%有抑郁。逻辑回归分析显示，入院时卒中严重程度、短期和长期功能结局与PD独立相关。逻辑回归显示PSD与PD及未婚独立相关。Cox回归分析显示，PD和PSD均与高长期死亡率相关。
本研究确定了几个与PSD相关的因素。PD预示入院时卒中更严重，短期和长期功能改善均较少。PD和PSD均预示更高的长期死亡率。
Zotero 插件