Please use this identifier to cite or link to this item:
https://observatorio.fm.usp.br/handle/OPI/13885
Title: | 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 |
Authors: | MELLO, Roberta Ferreira de; SANTOS, Itamar de Souza; ALENCAR, Airlane Pereira; BENSENOR, Isabela Martins; LOTUFO, Paulo Andrade; GOULART, Alessandra Carvalho |
Citation: | JOURNAL OF STROKE & CEREBROVASCULAR DISEASES, v.25, n.3, p.618-625, 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 followup. 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. |
Appears in Collections: | Artigos e Materiais de Revistas Científicas - FM/MCM Artigos e Materiais de Revistas Científicas - HU Artigos e Materiais de Revistas Científicas - LIM/20 Artigos e Materiais de Revistas Científicas - LIM/51 Artigos e Materiais de Revistas Científicas - ODS/03 |
Files in This Item:
File | Description | Size | Format | |
---|---|---|---|---|
art_MELLO_Major_Depression_as_a_Predictor_of_Poor_LongTerm_2016.PDF Restricted Access | publishedVersion (English) | 284.48 kB | Adobe PDF | View/Open Request a copy |
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.