RT杂志文章SR电子T1抑郁症状与急性中风风险:卒中间期病例对照研究半岛投注体育官网10.1212 / WNL.0000000000207093墨菲、罗伯特·P·雷丁、卡特里奥娜·罗森格伦、安妮卡·贾奇、康纳·汉基、格雷姆·j·弗格森、约翰·阿尔瓦雷兹-伊格莱西亚斯、阿尔贝托·奥维斯加兰、沙赫拉姆·瓦赛、穆罕默德·麦克德莫特、克洛达赫·艾弗森、赫勒·克林根贝格·拉纳斯、费尔南多·侯赛因、法瓦兹·泽隆科夫斯卡、安娜·奥古兹、阿伊特金·奥古尼伊、阿德索拉·Damasceno、阿尔贝蒂诺·沙维尔、丹尼斯·阿韦祖姆、阿尔瓦罗·王、兴宇·朗霍恩、彼得·尤瑟夫、萨利姆·奥唐奈、马丁·艾尔,YR 2023 UL http://n.半岛投注体育官网neurology.org/content/early/2023/03/08/WNL.0000000000207093.abstract AB背景和目的抑郁症已被报道为急性中风的危险因素,这主要基于高收入国家的研究。在INTERSTROKE研究中,我们探讨了抑郁症状对急性卒中风险和1个月预后的影响,包括世界各地区、亚人群和卒中类型。病例为CT或MRI确诊的急性住院卒中患者,对照组根据年龄、性别和部位进行匹配。标准化问题被问及过去12个月内自我报告的抑郁症状,并记录了处方抗抑郁药物的使用情况。多变量条件logistic回归用于确定卒中前抑郁症状与急性卒中风险的相关性。采用调整后的有序logistic回归探讨卒中前抑郁症状与卒中后功能结局的相关性,并在卒中后1个月用改良rankin量表进行测量。结果26877例患者中女性占40.4%,平均年龄61.7±13.4岁。与对照组相比,病例在过去12个月内抑郁症状的患病率较高(18.3%vs.14.1%,p < 0.001),并因地区而异(p交互作用< 0.001),中国患病率最低(对照组为6.9%),南美洲患病率最高(对照组为32.2%)。 In multivariable analyses pre-stroke depressive symptoms were associated with greater odds of acute stroke (OR 1.46, 95%CI 1.34–1.58), which was significant for both intracerebral hemorrhage (OR 1.56, 95%CI 1.28–1.91) and ischemic stroke (OR 1.44, 95%CI 1.31–1.58). A larger magnitude of association with stroke was seen in patients with a greater burden of depressive symptoms. While pre-admission depressive symptoms were not associated with a greater odds of worse baseline stroke severity (OR 1.02, 95%CI 0.94–1.10), they were associated with a greater odds of poor functional outcome at 1-month after acute stroke (OR 1.09, 95%CI 1.01–1.19).DiscussionIn this global study we recorded that depressive symptoms are an important risk factor for acute stroke, including both ischemic and hemorrhagic stroke. Pre-admission depressive symptoms were associated with poorer functional outcome, but not baseline stroke severity, suggesting an adverse role of depressive symptoms in post-stroke recovery.
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