TY - JOUR
T1 - Depressive symptom prevalence after intracerebral hemorrhage
T2 - A multi-center study
AU - Francis, Brandon A.
AU - Beaumont, Jennifer
AU - Maas, Matthew B.
AU - Liotta, Eric M.
AU - Cella, David
AU - Prabhakaran, Shyam
AU - Holl, Jane Louise
AU - Kho, Abel
AU - Naidech, Andrew M.
N1 - Funding Information:
We acknowledge the centers who contributed medication data to HealthLNK, Loyola University Medical Center, Northwestern Medicine, Bill Galanter, MD at University of Illinois Medical Center, Bala Hota, MD at Rush University Medical Center, and David Meltzer MD, PhD at the University of Chicago Medical Center. For this type of study formal consent is not required. Statistical analysis was performed by AN under guidance from JB. This project was supported by grant number K18HS023437 from the Agency for Healthcare Research and Quality to Dr. Naidech. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality or the National Institutes of Health. This work was supported in part by NINDS contract HHSN271201200036C to Dr. Cella. Dr. Maas is supported by National Institute of Neurologic Disorders and Stroke grant K23NS092975. Dr. Liotta is supported by the National Institutes of Health’s National Center for Advancing Translational Sciences, Grant Number KL2TR001424. Dr. Holl reports research support from AHRQ HS000078–18, and past support from NICHD Project Number 275201200007I-2-27500010-1.
Funding Information:
This project was supported by grant number K18HS023437 from the Agency for Healthcare Research and Quality to Dr. Naidech. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality or the National Institutes of Health. This work was supported in part by NINDS contract HHSN271201200036C to Dr. Cella. Dr. Maas is supported by National Institute of Neurologic Disorders and Stroke grant K23NS092975.
Funding Information:
Dr. Liotta is supported by the National Institutes of Health’s National Center for Advancing Translational Sciences, Grant Number KL2TR001424. Dr. Holl reports research support from AHRQ HS000078–18, and past support from NICHD Project Number 275201200007I-2-27500010-1.
Publisher Copyright:
© The Author(s).
PY - 2018
Y1 - 2018
N2 - 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 4.5– 11.5, 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.
AB - 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 4.5– 11.5, 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.
KW - Antidepressant medication
KW - Depression
KW - Intracerebral hemorrhage
KW - Neurocritical care
KW - Quality of life
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U2 - 10.1186/s41687-018-0083-0
DO - 10.1186/s41687-018-0083-0
M3 - Article
C2 - 30470937
AN - SCOPUS:85083726965
VL - 2
JO - Journal of Patient-Reported Outcomes
JF - Journal of Patient-Reported Outcomes
SN - 2509-8020
M1 - 55
ER -