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Major Depression as a Predictor of Poor Long-Term Survival in a Brazilian Stroke Cohort (Study of Stroke Mortality and Morbidity in Adults) EMMA study
- Source :
- Journal of Stroke and Cerebrovascular Diseases. 25:618-625
- Publication Year :
- 2016
- Publisher :
- Elsevier BV, 2016.
-
Abstract
- Background The influence of poststroke depression on long-term survival is poorly investigated. Thus, we aimed to evaluate the influence of major depression disorder (MDD) on long-term survival in the participants from The Study of Stroke Mortality and Morbidity in Adults (EMMA Study) in Sao Paulo, Brazil. 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. 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). Conclusion Our findings suggest that incident MDD is a potential marker of poor prognosis 1 year after stroke.
- Subjects :
- Adult
Male
medicine.medical_specialty
Severity of Illness Index
Statistics, Nonparametric
Cohort Studies
03 medical and health sciences
Age Distribution
Sex Factors
0302 clinical medicine
Internal medicine
Humans
Medicine
030212 general & internal medicine
Survival rate
Stroke
Depression (differential diagnoses)
Survival analysis
Aged
Aged, 80 and over
Psychiatric Status Rating Scales
Depressive Disorder, Major
business.industry
Proportional hazards model
Rehabilitation
Middle Aged
medicine.disease
Survival Analysis
Patient Health Questionnaire
Cohort
Physical therapy
Female
Surgery
Neurology (clinical)
Cardiology and Cardiovascular Medicine
business
Brazil
030217 neurology & neurosurgery
Cohort study
Subjects
Details
- ISSN :
- 10523057
- Volume :
- 25
- Database :
- OpenAIRE
- Journal :
- Journal of Stroke and Cerebrovascular Diseases
- Accession number :
- edsair.doi.dedup.....f36d419851ef7c12769a512a0d6f0ae4
- Full Text :
- https://doi.org/10.1016/j.jstrokecerebrovasdis.2015.11.021