Effect of Post-stroke Depression on Functional Outcomes of Patients With Stroke in the Rehabilitation Ward: A Retrospective Cohort Study
Yoshitaka Wada, Yohei Otaka, T. Yoshida, Kanako Takekoshi, Raku Takenaka, Yuki Senju, Hirofumi Maeda, Seiko Shibata, Taro Kishi, Satoshi Hirano
Abstract
To investigate the prevalence of post-stroke depression in a rehabilitation ward and elucidate its impact on functional improvement and outcomes. Retrospective cohort study. A convalescent rehabilitation ward at a University Hospital. A total of 114 patients with stroke (mean [standard deviation] age, 67.2 [13.5] years; male, 76) assessed at two weeks following admission using the Mini-International Neuropsychiatric Interview were enrolled. Functional Independence Measure efficiency during hospitalization in the ward. Eleven patients (9.6%) had depression based on the Mini-International Neuropsychiatric Interview. Total Functional Independence Measure efficiency and Functional Independence Measure 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 = 0.027; and 0.56 [0.38–0.80] vs. 0.42 [0.18–0.49], p = 0.023, respectively). Patients in the non-depression group had higher Functional Independence Measure scores at discharge (median [interquartile range]:116.0 [104.5–123.0] vs. 104.0 [82.5–112.0], p = 0.013, respectively), and were more likely to be discharged home (80.6% vs 36.4%, p = 0.003). Furthermore, patients in the depression group also stayed significantly longer in the ward (71.0 [36.1] vs. 106.1 [43.3], p = 0.010). 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.