Effect of Post-stroke Depression on Functional Outcomes of Patients With Stroke in the Rehabilitation Ward: A Retrospective Cohort Study

IF 1.9 Q2 REHABILITATION

Archives of rehabilitation research and clinical translation Pub Date : 2023-12-01 DOI:10.1016/j.arrct.2023.100287

Yoshitaka Wada MD, PhD , Yohei Otaka MD, PhD , Taiki Yoshida OTR, PhD , Kanako Takekoshi RN , Raku Takenaka MD , Yuki Senju MD, PhD , Hirofumi Maeda MD, PhD , Seiko Shibata MD, PhD , Taro Kishi MD, PhD , Satoshi Hirano MD, PhD

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Abstract

Objective

To investigate the prevalence of post-stroke depression in a rehabilitation ward and elucidate its effect on functional improvement and outcomes.

Design

Retrospective cohort study.

Setting

A convalescent rehabilitation ward at a University Hospital.

Participants

A total of 114 patients with stroke (mean [SD] age, 67.2 [13.5] years; men, 76) assessed at 2 weeks after admission using the Mini-International Neuropsychiatric Interview were enrolled.

Main Outcome Measure

Functional independence measure (FIM) efficiency during hospitalization in the ward.

Results

Eleven patients (9.6%) had depression based on the Mini-International Neuropsychiatric Interview. Total FIM efficiency and FIM efficiency in the subtotal of motor items were significantly higher in the non-depression group than in the depression group (median [interquartile range]: 0.69 [0.39-0.95] vs 0.41 [0.24-0.63], P=.027; and 0.56 [0.38-0.80] vs 0.42 [0.18-0.49], P=.023, respectively). Patients in the non-depression group had higher FIM scores at discharge (median [interquartile range]: 116.0 [104.5-123.0] vs 104.0 [82.5-112.0], P=.013, respectively), and were more likely to be discharged home (80.6% vs 36.4%, P=.003). Furthermore, patients in the depression group also stayed significantly longer in the ward (71.0 [36.1] vs 106.1 [43.3], P=.010).

Conclusions

Patients with post-stroke depression showed poorer efficiency of functional recovery than those without depression. A future multicenter study with a larger sample size is needed to verify these findings.

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脑卒中后抑郁对康复病房脑卒中患者功能结果的影响：一项回顾性队列研究

目的调查康复病房中脑卒中后抑郁症的患病率，并阐明其对功能改善和预后的影响.设计回顾性队列研究.设置一所大学医院的疗养康复病房.参与者共有 114 名脑卒中患者（平均 [SD] 年龄为 67.2 [13.主要结果测量在病房住院期间的功能独立性测量（FIM）效率。结果根据迷你国际神经精神访谈，有7名患者（9.6%）患有抑郁症。非抑郁组的 FIM 总效率和运动项目小计的 FIM 效率明显高于抑郁组（中位数[四分位间范围]：0.69 [0.39-0.40]] ：分别为 0.69 [0.39-0.95] vs 0.41 [0.24-0.63]，P=.027；0.56 [0.38-0.80] vs 0.42 [0.18-0.49]，P=.023）。非抑郁组患者出院时的 FIM 评分较高（中位数[四分位数间距]：116.0 [104.5-111.0]; 中位数[四分位数间距分别为 116.0 [104.5-123.0] vs 104.0 [82.5-112.0]，P=.013），并且更有可能出院回家（80.6% vs 36.4%，P=.003）。此外，抑郁组患者在病房的逗留时间也明显更长（71.0 [36.1] vs 106.1 [43.3]，P=.010）。结论卒中后抑郁患者的功能恢复效率低于无抑郁患者，需要今后开展样本量更大的多中心研究来验证这些发现。

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