Title
Risk factors associated with post-stroke depression and cognition in spontaneous intracerebral hemorrhage: a meta-analysis
Drs. Daniel F. Hanley and Wendy Ziai
Background
Post-stroke depression (PSD) is under-studied in spontaneous intracerebral hemorrhage (ICH). PSD has major implications on post-stroke depression including both quality of life and functional recovery. Identifying early PSD could have the potential to address both physical and emotional needs with patients with large ICH. The objective of the analysis is to perform meta-analysis across available ICH trial data to further investigate which clinical and demographic features of ICH would correlate with PSD and later perform longitudinal analysis to study the trajectory of outcomes over time.
Hypotheses
We hypothesize that higher ICH severity and early cognitive impairment in addition to demographic characteristics are independently associated with post-stroke depression and that this would impact both early and later outcome trajectory in ICH population.
Methods
1) Perform univariate assessments to identify factors associated with PSD and/or cognitive function.
2) Multivariable logistic/linear regression models to control for various demographics and severity factors associated with PSD at a given time point, and
3) Longitudinal data analysis to assess the trend/trajectory over time.
References and Appendices:
• Qureshi AI, Tuhrim S, Broderick JP, Batjer HH, Hondo H, Hanley DF. Spontaneous intracerebral hemorrhage. N Engl J Med. 2001;344(19):1450-1460. doi:10.1056/NEJM200105103441907
• Koivunen R-J, Harno H, Tatlisumak T, Putaala J. Depression, anxiety, and cognitive functioning after intracerebral hemorrhage. Acta Neurol Scand. 2015;132(3):179-184. doi:10.1111/ane.12367
• Stern-Nezer S, Eyngorn I, Mlynash M, et al. Depression one year after hemorrhagic stroke is associated with late worsening of outcomes. NeuroRehabilitation. 2017;41(1):179-187. doi:10.3233/NRE-171470
• Christensen MC, Mayer SA, Ferran J-M, Kissela B. Depressed mood after intracerebral hemorrhage: the FAST trial. Cerebrovasc Dis. 2009;27(4):353-360. doi:10.1159/000202012
Funding
Academic Investigator initiated Brain Injury Outcomes - Johns Hopkins University