- 作者：Roberta Ferreira de Mello ; ME* ; robertamello@hu.usp.br" class="auth_mail" title="E-mail the corresponding author ; Itamar de Souza Santos ; PhD* ; &dagger ; ; Airlane Pereira Alencar ; PhD&Dagger ; ; Isabela Martins Benseñ ; or ; PhD* ; &dagger ; ; Paulo Andrade Lotufo ; PhD* ; &dagger ; ; Alessandra Carvalho Goulart ; PhD*
- 关键词：Stroke ; depression ; survival ; mortality ; epidemiology ; cohort
- 刊名：Journal of Stroke and Cerebrovascular Diseases
- 出版年：2016
- 出版时间：March 2016
- 年：2016
- 卷：25
- 期：3
- 页码：618-625
- 全文大小：284 K
absSec_2">Methods
We prospectively evaluated ischemic and hemorrhagic stroke (HS) cases from the EMMA Study. Baseline and stroke characteristics and cardiovascular risk factors were evaluated according to MDD assessed by the Patient Health Questionnaire, which was applied 30 days after index event and periodically during 1-year follow-up. We performed Kaplan–Meier survival analysis, as well as crude and multiple Cox proportional hazards models.
absSec_3">Results
In this subset of the EMMA Study, we evaluated 164 (85.9%) patients with ischemic stroke and 27 (14.1%) with HS. Among these, overall incidence of MDD was 25.1% during 1 year of follow-up, regardless stroke subtype. The peak rate of major depression postacute event was beyond 1 month. We observed a lower survival rate among individuals who developed poststroke MDD than among those who did not develop this condition after 1 year of follow-up (85.4% versus 96.5%, log rank P = .006). After multiple analysis, we kept a higher risk of all-cause mortality among those who developed MDD compared to participants without MDD (hazard ratio = 4.60, 95% confidence interval = 1.36-15.55, P = .01).
absSec_4">Conclusion
Our findings suggest that incident MDD is a potential marker of poor prognosis 1 year after stroke.