|
|
Occurrence of depression in patients with acute ischemic stroke after intravenous thrombolysis and construction of prediction model |
CHEN Rao, PENG Jinfeng, SHEN Ting |
Emergency Department, the Third Hospital of Mianyang /Sichuan Mental Health Center, Mianyang 621000, China |
|
|
Abstract Objective To analyze the occurrence of depression in patients with acute ischemic stroke (AIS) after intravenous thrombolysis, and construct a prediction model. Methods A total of 243 patients with AIS who underwent intravenous thrombolysis in the Third Hospital of Mianyang from January 2020 to December 2021 were selected as the study subjects. According to the presence or absence of depression after intravenous thrombolysis, the patients were divided into depression group (n=78) and non-depression group (n=165). Baseline data of the two groups were compared. Logistic regression analysis was conducted to identify the influencing factors of depression after intravenous thrombolysis for AIS, and a prediction model was constructed. The predictive value of the model was evaluated using the receiver operating characteristic (ROC) curve. Results Univariate analysis showed that there were statistically significant differences between the two groups in terms of age, BMI, accompanying mode, recent occurrence of negative life events, NIHSS score at admission and complications after thrombolysis. Logistic regression analysis found that age ≥ 60 years old, BMI ≥ 28 kg/m2, accompanied by nursing workers, negative life events occurring recently, the NIHSS score higher than 5 at admission, hemorrhage and ischemia-reperfusion injury after thrombolysis were risk factors for depression in patients with AIS after intravenous thrombolysis. A prediction model was constructed based on above-mentioned factors, and internal verification by Bootstrap method showed that the prediction curve was in good agreement with the standard model curve. ROC curve analysis showed that the sensitivity and specificity of the indicator Prob were 86.00% and 70.50%. Conclusion Age, BMI, accompanying mode, presence or absence of negative life events recently, the NIHSS score at admission and complications after thrombolysis are influencing factors of depression in patients with AIS after intravenous thrombolysis. The prediction model constructed based on above factors provides certain reference for predicting depression in AIS after intravenous thrombolysis.
|
Received: 03 August 2023
|
|
|
|
|
[1] 郑宗菊, 鄢宗仁, 秦枫, 等. 血浆皮质醇, 脑源性神经营养因子, 亚硝酸根水平与急性缺血性脑卒中后抑郁状态相关性研究[J]. 创伤与急危重病医学, 2021, 9(5) : 331-336. [2] Hou D, Wang C, Luo Y, et al.Systemic immune-inflammation index (SII) but not platelet-albumin-bilirubin (PALBI) grade is associated with severity of acute ischemic stroke (AIS)[J]. Int J Neurosci, 2021, 131(12) : 1203-1208. [3] Zhang J, Chen S, Shi S, et al.Direct endovascular treatment versus bridging therapy in patients with acute ischemic stroke eligible for intravenous thrombolysis: systematic review and meta-analysis[J]. J Neurointerv Surg, 2022, 14(4) : 321-325. [4] 李娜, 吴芬香, 李涛, 等. 老年急性缺血性脑卒中患者静脉溶栓后早期神经功能恶化的相关因素分析[J]. 中华老年医学杂志, 2021, 40(8) : 1005-1009. [5] 胡婷婷, 马靓, 徐艳, 等. 静脉溶栓治疗对急性缺血性卒中患者卒中后抑郁的影响[J]. 国际脑血管病杂志, 2022, 30(2) : 120-123. [6] 中华医学会神经病学分会脑血管病学组急性缺血性脑卒中诊治指南撰写组. 中国急性缺血性脑卒中诊治指南2010[J]. 中国临床医生, 2011, 2(3) : 50-59. [7] 王少石, 周新雨, 朱春燕, 等. 卒中后抑郁临床实践的中国专家共识[J]. 中国卒中杂志, 2016, 11(8) : 685-693. [8] 中华医学会精神病学分会. 中国精神障碍分类与诊断标准第三版 (精神障碍分类)[J]. 中华精神科杂志, 2001, 34(3) : 184-188. [9] Alemseged F, Rocco A, Arba F, et al.Basilar Artery Treatment and Management (BATMAN) Collaboration Investigators. Posterior National Institutes of Health Stroke Scale Improves Prognostic Accuracy in Posterior Circulation Stroke[J]. Stroke, 2022, 53(4) : 1247-1255. [10] 陈韵, 陈坤, 王桂斌, 等. 急性缺血性脑卒中患者卒中后抑郁发病率与危险因素分析[J]. 湖南师范大学学报 (医学版) , 2021, 18(2) : 20-23. [11] 彭金凤, 陈娆. 缺血性卒中静脉溶栓患者抑郁的影响因素研究[J]. 护理学杂志, 2021, 36(13) : 76-78. [12] 王宁, 和杰, 郭娜, 等. 急性缺血性脑卒中患者发生抑郁的危险因素分析及预测指标探究[J]. 甘肃科学学报, 2022, 34(2) : 61-65. [13] 罗爱华, 卢长东, 王任昌, 等. 血清肥胖抑制素、脑源性神经营养因子水平与缺血性脑卒中并发抑郁的关系[J]. 中西医结合心脑血管病杂志, 2022, 20(1) : 135-140. [14] Meng J, Du J, Diao X, et al.Effects of an evidence-based nursing intervention on prevention of anxiety and depression in the postpartum period[J]. Stress Health, 2022 , 38(3) : 435-442. [15] 唐玉婷, 朱宁宁, 李敏, 等. 脑卒中后急性期抑郁发生状况及预测因素[J]. 中国实用护理杂志, 2020, 36(11) : 812-817. [16] Huang L, Zhang C, Xu J, et al.Function of a Psychological Nursing Intervention on Depression, Anxiety, and Quality of Life in Older Adult Patients With Osteoporotic Fracture[J]. Worldviews Evid Based Nurs, 2021, 18(4) : 290-298. [17] 谭庆, 刘庆军, 刘曙东, 等. 阿替普酶静脉溶栓与急性脑梗死后卒中后抑郁相关性的研究进展[J]. 国际神经病学神经外科学杂志, 2021, 48(2) : 189-192. [18] Liu X, Wang Y, Wang S, et al.The efficacy of psychological interventions for depressed primary caregivers of patients with Alzheimer’s disease: A systematic review and meta-analysis[J]. J Nurs Scholarsh, 2022, 54(3) : 355-366. |
|
|
|