Depression and risk of stroke morbidity and mortality: a meta-analysis and systematic review.
Depression and risk of stroke morbidity and mortality: a meta-analysis and systematic review.
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DOI：
10.1001/jama.2011.1282
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发表时间：
2011-09-21
影响因子：
120.7
通讯作者：
Hu, Frank B.
中科院分区：
文献类型：
--
作者：
Pan, An;Sun, Qi;Okereke, Olivia I.;Rexrode, Kathryn M.;Hu, Frank B.
几项研究表明，抑郁症与中风风险的增加有关；然而，结果并不一致。对评估抑郁症与成人发生中风风险之间的关系的前瞻性研究进行系统回顾和荟萃分析。通过检索MEDLINE、EMBASE和SouthInfo数据库(至2011年5月)，人工检索关键检索文章的书目和相关综述。我们纳入了前瞻性队列研究，这些研究报告了根据基线的中风发病率或死亡率的风险估计，或通过自我报告的量表或临床医生诊断评估的最新抑郁状态。两位独立的评价者提取了基线时的抑郁状态、中风的风险估计、研究质量以及用于评估抑郁和中风的方法的数据。风险比(HR)在适当的时候使用固定效应或随机效应模型进行合并。关联性在代表不同参与者和研究特征的小组中进行测试。采用漏斗图和Begg检验评价发表偏倚。这项研究产生了28项前瞻性队列研究(n=317540名参与者)，在2年至29年的随访期内报告了8478例中风病例(发病率和死亡率)。合并调整后的RR：总卒中为1.45(95%可信区间为1.29-1.63；异质性P=0.001；随机效应模型)，致死性卒中为1.55(1.25-1.93；固定效应模型为0.31)，缺血性卒中为1.25(1.11-1.40；P-异质性为0.34；固定效应模型)。与抑郁症相关的估计绝对风险差异为每年每10万人中106例总中风、53例缺血性中风和22例致死性中风。与抑郁相关的整体中风风险增加在大多数亚组中都是一致的。抑郁症与中风发病率和死亡率的显著增加有关。
Several studies have suggested that depression is associated with an increased risk of stroke; however, the results are inconsistent. To conduct a systematic review and meta-analysis of prospective studies assessing the association between depression and risk of developing stroke in adults. A search of MEDLINE, EMBASE, and PsychINFO databases (to May 2011) was supplemented by manual searches of bibliographies of key retrieved articles and relevant reviews. We included prospective cohort studies that reported risk estimates of stroke morbidity or mortality by baseline or updated depression status assessed by self-reported scales or clinician diagnosis. Two independent reviewers extracted data on depression status at baseline, risk estimates of stroke, study quality, and methods used to assess depression and stroke. Hazard ratios (HRs) were pooled using fixed-effect or random-effects models when appropriate. Associations were tested in subgroups representing different participant and study characteristics. Publication bias was evaluated with funnel plots and Begg test. The search yielded 28 prospective cohort studies (n = 317540 participants) that reported 8478 stroke cases (morbidity and mortality) during a follow-up period ranging from 2 to 29 years. The pooled adjusted HRs were 1.45 (95% confidence interval [CI], 1.29–1.63; P-for-heterogeneity <0.001; random-effects model) for total stroke, 1.55 (1.25–1.93; P-for-heterogeneity = 0.31; fixed-effects model) for fatal stroke (8 studies), and 1.25 (1.11–1.40; P-for-heterogeneity = 0.34; fixed-effects model) for ischemic stroke (6 studies). The estimated absolute risk differences associated with depression were 106 cases for total stroke, 53 cases for ischemic stroke, and 22 cases for fatal stroke per 100 000 individuals per year. The increased risk of total stroke associated with depression was consistent across most subgroups. Depression is associated with a significantly increased risk of stroke morbidity and mortality.
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影响因子：
1.9
作者：
Duval, S;Tweedie, R
通讯作者：
Tweedie, R
影响因子：
10.6
作者：
Lee, Hsin-Chien;Lin, Herng-Ching;Tsai, Shang-Ying
通讯作者：
Tsai, Shang-Ying
DOI：
10.1016/0197-2456(86)90046-2
发表时间：
1986-09-01
期刊：
CONTROLLED CLINICAL TRIALS
影响因子：
--
作者：
DERSIMONIAN, R;LAIRD, N
通讯作者：
LAIRD, N
影响因子：
8.3
作者：
Liebetrau, Martin;Steen, Bertil;Skoog, Ingmar
通讯作者：
Skoog, Ingmar
影响因子：
8.3
作者：
Goldstein, Larry B.;Bushnell, Chair Cheryl D.;Pearson, Thomas A.
通讯作者：
Pearson, Thomas A.