Increase of Medical Hospital Length of Stay by Depression in Stroke and Amputation Patients: A Pilot Study

Schubert, Daniel; Burns, Robert; Paras, Wilfredo; Sioson, Eulogio R.

doi:10.1159/000288575

Cited by 79 publications

(34 citation statements)

References 12 publications

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“…2 PSD is common and associated with many negative consequences, including lengthened hospital stays, prolonged recovery time, increased mortality, and impaired functional outcomes. [3][4][5][6][7] Several studies have reported that stroke survivors with PSD or depressive symptoms may demonstrate worse functional outcomes, impairment, and recovery compared to those without depression. 3,4,8,9 Although many studies have linked PSD to worse functional outcomes, there is little known about the impact of PSD treatment and improvement on function after stroke.…”

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confidence: 99%

Poststroke depression and treatment effects on functional outcomes

Schmid

Kroenke

Hendrie³

et al. 2011

Neurology

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Poststroke depression and treatment effects on functional outcomes

Schmid

Kroenke

Hendrie³

et al. 2011

Neurology

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“…Most studies have examined the impact of PSD on length of stay (LOS) in a rehabilitation setting, and their findings are equivocal. Some studies found an association between PSD and increased LOS (eg, Schubert et al 5 ), whereas other studies did not demonstrate such a relation (eg, Gillen et al 6 ). Recently, PSD among veterans has been found to be associated with more outpatient visits and an increase in the total length of rehospitalization in the 1-year 7 as well as the 3-year 8 period after initial stroke hospitalization.…”

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confidence: 99%

Impact of Preexisting Depression on Length of Stay and Discharge Destination Among Patients Hospitalized for Acute Stroke

Nuyen

Spreeuwenberg²,

Groenewegen³

et al. 2008

Stroke

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Background and Purpose-There exists limited knowledge regarding the relation between depression and healthcare utilization in stroke patients. The objective of this register-based study was to examine the impact of having preexisting depression at the time of hospital admission for acute stroke on length of hospital stay and discharge destination. Methods-Data from a general-practice database were linked to those of a hospital database to identify patients hospitalized for stroke and were used to categorize these patients into 3 groups based on preexisting mental health (MH) status at admission, ie, those with preexisting depression, those with another preexisting MH condition, and those without any preexisting MH condition. Multilevel analyses controlling for several potentially important covariates were performed to estimate the associations under study. Results-Both patients with preexisting depression (nϭ41) and those with another preexisting MH condition (nϭ62) did not differ significantly from patients without any preexisting MH condition (nϭ211) regarding length of hospital stay for acute stroke. Among patients who survived hospitalization, those with preexisting depression had significantly higher odds of being discharged to an institution instead of their home than did patients without any preexisting MH condition. Having another preexisting MH condition had no significant effect on discharge destination. Conclusions-Having preexisting depression at admission seems to be a relevant factor in determining discharge to institutional care after acute stroke hospitalization. Further research is needed to determine the mechanism(s) through which preexisting depression decreases the chances of being discharged to home. (Stroke. 2008;39:132-138.)

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“…1 PSD is commonly unrecognized and untreated in clinical practice. 1,5 According to Schubert et al, 8 nonpsychiatric physicians fail to diagnose 50% to 80% of the actually existing depression. PSD has been related to physical handicap and the limitations in activities of daily living (ADL).…”

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Frequency and Clinical Determinants of Poststroke Depression

Pohjasvaara

Leppävuori

Siira

et al. 1998

Stroke

256

219

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Background and Purpose —Previous studies have shown a large variation concerning the frequency of poststroke depression. This variation is caused by differences in patient populations, psychiatric assessment methods, and diagnostic criteria. In this study, we evaluated the frequency and clinical correlates of poststroke depression in a large well-defined stroke cohort. Methods —We studied a consecutive series of 486 patients with ischemic stroke aged from 55 to 85 years. Of these, 277 patients underwent a comprehensive psychiatric evaluation, including the Present State Examination, from 3 to 4 months after ischemic stroke. The criteria of the Diagnostic and Statistical Manual of Mental Disorders , edition 3, revised (DSM-III-R), were used for the diagnosis of depressive disorders. Results —The frequency of any depressive disorder was 40.1% (n=111). Major depression was diagnosed in 26.0% (n=72) and minor depression in 14.1% (n=39). Major depression with no other explanatory factor besides stroke was diagnosed in 18.0% (n=49) of the patients. Comparing depressed and nondepressed patients, we found no statistically significant difference in sex, age, education, stroke type, stroke localization, stroke syndrome, history of previous cerebrovascular disease, or frequency of DSM-III-R dementia. According to the multiple logistic regression model, dependency in daily life correlated with the diagnosis of depression (odds ratio [OR], 1.8; 95% confidence interval [CI], 1.1 to 3.1) and with the diagnosis of major depression (OR, 2.9; 95% CI, 1.6 to 5.5). A history of previous depressive episodes also correlated with the diagnosis of depression (OR, 2.3; 95% CI, 1.3 to 4.4) and with the diagnosis of major depression (OR, 2.9; 95% CI, 1.6 to 5.5), whereas solely stroke-related major depression correlated only weakly with stroke severity as measured on the Scandinavian Stroke Scale (OR, 1.1; 95% CI, 1.0 to 1.1). Conclusions —Clinically significant depression is frequent after ischemic stroke. We emphasize the importance of the psychiatric examination of poststroke patients, especially those with a significant disability and with a history of prior depressive episodes.

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Increase of Medical Hospital Length of Stay by Depression in Stroke and Amputation Patients: A Pilot Study

Cited by 79 publications

References 12 publications

Poststroke depression and treatment effects on functional outcomes

Poststroke depression and treatment effects on functional outcomes

Impact of Preexisting Depression on Length of Stay and Discharge Destination Among Patients Hospitalized for Acute Stroke

Frequency and Clinical Determinants of Poststroke Depression

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