Cargando…

A new nomogram including total cerebral small vessel disease burden for individualized prediction of early-onset depression in patients with acute ischemic stroke

OBJECTIVES: The present study was designed to evaluate the effects of total cerebral small vessel disease (CSVD) on early-onset depression after acute ischemic stroke (AIS), and to develop a new nomogram including total CSVD burden to predict early-onset post-stroke depression (PSD). METHODS: We con...

Descripción completa

Detalles Bibliográficos
Autores principales: Zhou, Lihua, Chen, Licong, Ma, Linqing, Diao, Shanshan, Qin, Yiren, Fang, Qi, Li, Tan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9552538/
https://www.ncbi.nlm.nih.gov/pubmed/36238936
http://dx.doi.org/10.3389/fnagi.2022.922530
_version_ 1784806271324520448
author Zhou, Lihua
Chen, Licong
Ma, Linqing
Diao, Shanshan
Qin, Yiren
Fang, Qi
Li, Tan
author_facet Zhou, Lihua
Chen, Licong
Ma, Linqing
Diao, Shanshan
Qin, Yiren
Fang, Qi
Li, Tan
author_sort Zhou, Lihua
collection PubMed
description OBJECTIVES: The present study was designed to evaluate the effects of total cerebral small vessel disease (CSVD) on early-onset depression after acute ischemic stroke (AIS), and to develop a new nomogram including total CSVD burden to predict early-onset post-stroke depression (PSD). METHODS: We continuously enrolled patients with AIS who were hospitalized at the First Affiliated Hospital of Soochow University between October 2017 and June 2019. All patients were assessed for depressive symptoms using the 17-item Hamilton Depression Scale (HAMD-17) at 14 ± 2 days after the onset of AIS. The diagnosis for depression was made according to the American Diagnostic and Statistical Manual of Mental Disorders Version 5 (DSM-5). The demographic and clinical data were collected including total CSVD burden. On the basis of a multivariate logistic model, the independent factors of early-onset PSD were identified and the predictive nomogram was generated. The performance of the nomogram was evaluated by Harrell's concordance index (C-index) and calibration plot. RESULTS: A total of 346 patients were enrolled. When contrasted to a 0 score of total CSVD burden, the score ≥2 (moderate to severe total CSVD burden) was an independent risk factor for early-onset PSD. Besides, gender, cognitive impairments, baseline Barthel Index (BI), and plasma fibrinogen were independently associated with early-onset PSD. The nomogram based on all these five independent risk factors was developed and validated with an Area Under Curve (AUC) of 0.780. In addition, the calibration plot revealed an adequate fit of the nomogram in predicting the risk of early-onset depression in patients with AIS. CONCLUSIONS: Our study found the total CSVD burden score of 2–4 points was an independent risk factor of early-onset PSD. The proposed nomogram based on total CSVD burden, gender, cognitive impairments, baseline BI, and plasma fibrinogen concentration gave rise to a more accurate and more comprehensive prediction for early-onset PSD.
format Online
Article
Text
id pubmed-9552538
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-95525382022-10-12 A new nomogram including total cerebral small vessel disease burden for individualized prediction of early-onset depression in patients with acute ischemic stroke Zhou, Lihua Chen, Licong Ma, Linqing Diao, Shanshan Qin, Yiren Fang, Qi Li, Tan Front Aging Neurosci Aging Neuroscience OBJECTIVES: The present study was designed to evaluate the effects of total cerebral small vessel disease (CSVD) on early-onset depression after acute ischemic stroke (AIS), and to develop a new nomogram including total CSVD burden to predict early-onset post-stroke depression (PSD). METHODS: We continuously enrolled patients with AIS who were hospitalized at the First Affiliated Hospital of Soochow University between October 2017 and June 2019. All patients were assessed for depressive symptoms using the 17-item Hamilton Depression Scale (HAMD-17) at 14 ± 2 days after the onset of AIS. The diagnosis for depression was made according to the American Diagnostic and Statistical Manual of Mental Disorders Version 5 (DSM-5). The demographic and clinical data were collected including total CSVD burden. On the basis of a multivariate logistic model, the independent factors of early-onset PSD were identified and the predictive nomogram was generated. The performance of the nomogram was evaluated by Harrell's concordance index (C-index) and calibration plot. RESULTS: A total of 346 patients were enrolled. When contrasted to a 0 score of total CSVD burden, the score ≥2 (moderate to severe total CSVD burden) was an independent risk factor for early-onset PSD. Besides, gender, cognitive impairments, baseline Barthel Index (BI), and plasma fibrinogen were independently associated with early-onset PSD. The nomogram based on all these five independent risk factors was developed and validated with an Area Under Curve (AUC) of 0.780. In addition, the calibration plot revealed an adequate fit of the nomogram in predicting the risk of early-onset depression in patients with AIS. CONCLUSIONS: Our study found the total CSVD burden score of 2–4 points was an independent risk factor of early-onset PSD. The proposed nomogram based on total CSVD burden, gender, cognitive impairments, baseline BI, and plasma fibrinogen concentration gave rise to a more accurate and more comprehensive prediction for early-onset PSD. Frontiers Media S.A. 2022-09-27 /pmc/articles/PMC9552538/ /pubmed/36238936 http://dx.doi.org/10.3389/fnagi.2022.922530 Text en Copyright © 2022 Zhou, Chen, Ma, Diao, Qin, Fang and Li. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Aging Neuroscience
Zhou, Lihua
Chen, Licong
Ma, Linqing
Diao, Shanshan
Qin, Yiren
Fang, Qi
Li, Tan
A new nomogram including total cerebral small vessel disease burden for individualized prediction of early-onset depression in patients with acute ischemic stroke
title A new nomogram including total cerebral small vessel disease burden for individualized prediction of early-onset depression in patients with acute ischemic stroke
title_full A new nomogram including total cerebral small vessel disease burden for individualized prediction of early-onset depression in patients with acute ischemic stroke
title_fullStr A new nomogram including total cerebral small vessel disease burden for individualized prediction of early-onset depression in patients with acute ischemic stroke
title_full_unstemmed A new nomogram including total cerebral small vessel disease burden for individualized prediction of early-onset depression in patients with acute ischemic stroke
title_short A new nomogram including total cerebral small vessel disease burden for individualized prediction of early-onset depression in patients with acute ischemic stroke
title_sort new nomogram including total cerebral small vessel disease burden for individualized prediction of early-onset depression in patients with acute ischemic stroke
topic Aging Neuroscience
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9552538/
https://www.ncbi.nlm.nih.gov/pubmed/36238936
http://dx.doi.org/10.3389/fnagi.2022.922530
work_keys_str_mv AT zhoulihua anewnomogramincludingtotalcerebralsmallvesseldiseaseburdenforindividualizedpredictionofearlyonsetdepressioninpatientswithacuteischemicstroke
AT chenlicong anewnomogramincludingtotalcerebralsmallvesseldiseaseburdenforindividualizedpredictionofearlyonsetdepressioninpatientswithacuteischemicstroke
AT malinqing anewnomogramincludingtotalcerebralsmallvesseldiseaseburdenforindividualizedpredictionofearlyonsetdepressioninpatientswithacuteischemicstroke
AT diaoshanshan anewnomogramincludingtotalcerebralsmallvesseldiseaseburdenforindividualizedpredictionofearlyonsetdepressioninpatientswithacuteischemicstroke
AT qinyiren anewnomogramincludingtotalcerebralsmallvesseldiseaseburdenforindividualizedpredictionofearlyonsetdepressioninpatientswithacuteischemicstroke
AT fangqi anewnomogramincludingtotalcerebralsmallvesseldiseaseburdenforindividualizedpredictionofearlyonsetdepressioninpatientswithacuteischemicstroke
AT litan anewnomogramincludingtotalcerebralsmallvesseldiseaseburdenforindividualizedpredictionofearlyonsetdepressioninpatientswithacuteischemicstroke
AT zhoulihua newnomogramincludingtotalcerebralsmallvesseldiseaseburdenforindividualizedpredictionofearlyonsetdepressioninpatientswithacuteischemicstroke
AT chenlicong newnomogramincludingtotalcerebralsmallvesseldiseaseburdenforindividualizedpredictionofearlyonsetdepressioninpatientswithacuteischemicstroke
AT malinqing newnomogramincludingtotalcerebralsmallvesseldiseaseburdenforindividualizedpredictionofearlyonsetdepressioninpatientswithacuteischemicstroke
AT diaoshanshan newnomogramincludingtotalcerebralsmallvesseldiseaseburdenforindividualizedpredictionofearlyonsetdepressioninpatientswithacuteischemicstroke
AT qinyiren newnomogramincludingtotalcerebralsmallvesseldiseaseburdenforindividualizedpredictionofearlyonsetdepressioninpatientswithacuteischemicstroke
AT fangqi newnomogramincludingtotalcerebralsmallvesseldiseaseburdenforindividualizedpredictionofearlyonsetdepressioninpatientswithacuteischemicstroke
AT litan newnomogramincludingtotalcerebralsmallvesseldiseaseburdenforindividualizedpredictionofearlyonsetdepressioninpatientswithacuteischemicstroke