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

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dc.contributor Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.author MELLO, Roberta Ferreira de FMUSP-HC
SANTOS, Itamar de Souza FMUSP-HC
ALENCAR, Airlane Pereira
BENSENOR, Isabela Martins FMUSP-HC
LOTUFO, Paulo Andrade FMUSP-HC
GOULART, Alessandra Carvalho FMUSP-HC
dc.date.issued 2016
dc.identifier.citation JOURNAL OF STROKE & CEREBROVASCULAR DISEASES, v.25, n.3, p.618-625, 2016
dc.identifier.issn 1052-3057
dc.identifier.uri http://observatorio.fm.usp.br/handle/OPI/13885
dc.description.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.
dc.language.iso eng
dc.publisher ELSEVIER SCIENCE BV
dc.relation.ispartof Journal of Stroke & Cerebrovascular Diseases
dc.rights restrictedAccess
dc.subject Stroke; depression; survival; mortality; epidemiology; cohort
dc.subject.other poststroke depression; lesion location; mood disorders; mental-health; phq-9; surveillance; symptoms; risk; care; metaanalysis
dc.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
dc.type article
dc.rights.holder Copyright ELSEVIER SCIENCE BV
dc.description.group LIM/20
dc.description.group LIM/51
dc.identifier.doi 10.1016/j.jstrokecerebrovasdis.2015.11.021
dc.identifier.pmid 26725125
dc.type.category original article
dc.type.version publishedVersion
hcfmusp.author MELLO, Roberta Ferreira de:FM:
hcfmusp.author SANTOS, Itamar de Souza:FM:MCM
hcfmusp.author BENSENOR, Isabela Martins:FM:MCM
hcfmusp.author LOTUFO, Paulo Andrade:FM:MCM
hcfmusp.author GOULART, Alessandra Carvalho:HU:SCPACEX-62
hcfmusp.author.external · ALENCAR, Airlane Pereira:Univ Sao Paulo, Inst Math & Stat, BR-05508000 Sao Paulo, Brazil
hcfmusp.origem.id 2-s2.0-84959495701
hcfmusp.origem.id WOS:000371175900024
hcfmusp.publisher.city AMSTERDAM
hcfmusp.publisher.country NETHERLANDS
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dc.description.index MEDLINE
dc.identifier.eissn 1532-8511
hcfmusp.citation.scopus 17
hcfmusp.affiliation.country Brasil
hcfmusp.scopus.lastupdate 2021-07-23


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