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ORIGINAL RESEARCH article

Front. Neurol.
Sec. Stroke
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1385266
This article is part of the Research Topic Advances and controversies in ischemic stroke management: from prevention to diagnosis and acute treatment View all 89 articles

Intravenous Thrombolysis and Risk of Early-Onset Post-Stroke Depression: A Propensity Score Matched Cohort Study

Provisionally accepted
Jieyi Lu Jieyi Lu 1Lulu Zhang Lulu Zhang 1Yi Zhang Yi Zhang 2Huawu Mao Huawu Mao 3Qi Fang Qi Fang 4*
  • 1 The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
  • 2 Changzhou No.2 People's Hospital, Changzhou, Jiangsu Province, China
  • 3 Taizhou Second People's Hospital, Taizhou, China
  • 4 Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China

The final, formatted version of the article will be published soon.

    Background: Depression is common in stroke survivors and affects their recovery and quality of life (QoL). Intravenous thrombolysis (IVT) can improve post-stroke outcomes but the impact on early-onset post-stroke depression (PSD) is unclear. This was evaluated by comparing depression symptoms between patients with acute ischemic stroke (AIS) with vs. without IVT. Methods: This retrospective cohort study included 633 patients with AIS. The 17-item Hamilton Depression Rating Scale was used to evaluate depression in patients 14-21 days after stroke onset. Propensity score matching was used to minimize intervention bias between the two groups.Results: Of the 633 patients, 120 (19.0%) received IVT and 513 (81%) did not.Before matching, the prevalence of early-onset PSD was lower in the IVT group than in the non-IVT group (18.3% vs. 29.2%, P<0.05). In the multivariate logistic regression analysis, the risk of early-onset PSD was significantly lower in the IVT group than in the non-IVT group (odds ratio [OR]=0.48; 95% confidence interval: 0.28-0.83). The results were stable after adjusting for potential confounders by inverse probability of treatment weighting and using a pairwise algorithm based on propensity scores (ORs between 0.44 and 0.61, all P<0.05); were robust to unmeasured confounding as assessed by E-value analysis; and were consistent in subgroup analyses. Conclusion: IVT is associated with a reduced risk of early-onset PSD and can improve the QoL of patients with AIS during post-stroke recovery.

    Keywords: Intravenous thrombolysis, IVT, post-stoke depression, PSD, propensity score method,PSM, inverse probability of treatment weighting, IPTW, pairwise algorithmic, PA

    Received: 12 Feb 2024; Accepted: 15 Oct 2024.

    Copyright: © 2024 Lu, Zhang, Zhang, Mao and Fang. 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) or licensor 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.

    * Correspondence: Qi Fang, Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, China

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