Depressive symptom prevalence after intracerebral hemorrhage: a multi-center study
Depressive symptom prevalence after intracerebral hemorrhage: a multi-center study
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DOI：
10.1186/s41687-018-0083-0
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发表时间：
2018-01-01
影响因子：
2.7
通讯作者：
Naidech, Andrew M.
中科院分区：
文献类型：
--
作者：
Francis, Brandon A.;Beaumont, Jennifer;Naidech, Andrew M.
引言：脑出血（ICH）患者的抑郁症状很常见，并与不良结局相关。这是没有很好地描述抑郁症状的确定和治疗在大型队列的患者，以及抑郁症状是否会是一个潜在的目标，为改善outcome.Methods：数据电子检索从多中心EHR存储库在芝加哥，IL，从2006年至2012年（“多中心队列”）。在多中心队列研究中，我们从芝加哥的四所大学卫生系统中检索了诊断代码和药物数据。在单中心队列中，我们在ICH发作后1个月、3个月和12个月前瞻性筛查抑郁症状（NIH患者报告结局测量信息系统，PROMIS，T评分>= 60）。值得注意的是，并不是所有的抑郁症状的最佳特点，通过diagnosis codes.Results：诊断代码的抑郁症状长达3个月后，脑出血发作记录在132的3422（3.8%）的多中心队列不到10%的患者接受了典型的药物治疗抑郁症状，和< 2%一个月后。在单中心队列中，PROMIS评估提示116例患者中有26例（22.4%）有抑郁症状，筛选时更容易发现抑郁症状（OR 7.20，95%CI 4.51-1.5，P < 0.0001）。结果是相似的12个月后ICH.Conclusions：抑郁症状在ICH患者更常见于药物治疗或编码诊断在多中心队列，是一个潜在的机会，额外的治疗，以改善结果。目前没有AHA/阿萨治疗指南用于ICH患者的抑郁筛查。
Introduction: Depressive symptoms in patients with intracerebral hemorrhage (ICH) are common and are associated with worse outcomes. It is not well described how often depressive symptoms are ascertained and treated in large unselected cohorts of patients, and whether depressive symptoms would be a potential target for improving outcomes.Methods: Data were electronically retrieved from a multi-center EHR repository in Chicago, IL, from 2006 to 2012 ("multicenter cohort"). In the multicenter cohort, we retrieved diagnostic codes and medication data from four university health systems across Chicago. In the single center cohort, we prospectively screened for depressive symptoms (NIH Patient Reported Outcomes Measurement Information System, PROMIS, T Score >= 60), at one, three and twelve months after ICH onset. It should be noted that not all depressive symptoms are optimally characterized through diagnostic codes.Results: Diagnostic codes for depressive symptoms up to three months after ICH onset were recorded in 132 of 3422 (3.8%) of the multicenter cohort fewer than 10% of patients received a typical medication to treat depressive symptoms, and < 2% one month later. In the single-center cohort, PROMIS assessments were indicative of depressive symptoms in 26 of 116 (22.4%), and depressive symptoms were more likely to be found with screening (OR 7.20, 95% CI 4.51-1.5, P < 0.0001). Results were similar up to 12 months after ICH.Conclusions: Depressive symptoms in patients with ICH are more common than medication treatment or a coded diagnosis in a multi-center cohort, and are a potential opportunity for additional treatment to improve outcomes. There are currently no AHA/ASA treatment guidelines for depression screening of patients with ICH.