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. 2022 Aug 3;12(8):1032.
doi: 10.3390/brainsci12081032.

Higher Plasma Fibrinogen Level at Admission Is Associated with Post-Stroke Depression at Discharge

Juehua Zhu  1 , Li Wang  2 , Han Shao  1 , Xiang Tang  1 , Lulu Zhang  1 , Yun Zhou  1 , Yongjun Jiang  3 , Qi Fang  1 , Xiuying Cai  1
Affiliations

Higher Plasma Fibrinogen Level at Admission Is Associated with Post-Stroke Depression at Discharge

Juehua Zhu et al. Brain Sci. .

Abstract

Background: Post-stroke depression (PSD) is a common complication of stroke, which seriously affects the functional outcome of patients. Systemic low-grade inflammation associated with PSD has been shown to occur at several months to years, however, whether these inflammatory markers predicted PSD at an acute stage of stroke is controversial. Method: A total of 625 patients with acute ischemic stroke (219 female, 35.40%) were included in this study. PSD was diagnosed using the 17-item Hamilton depression scale (HAMD) at 7 days following discharge (7−14 days after stroke onset). Multivariable logistic regression analysis was applied to build a prediction model for PSD at discharge. Discrimination and calibration of the model were assessed by C-index, calibration plot. Internal validation was conducted using bootstrapping validation. Results: At discharge of hospitalization, 95 patients (15.20%) were diagnosed with PSD. Multivariable logistic regression suggested that female gender (OR = 2.043, 95% CI = 1.287−3.245, p = 0.002), baseline NIHSS (OR = 1.108, 95% CI = 1.055−1.165, p < 0.001) and fibrinogen (OR = 1.388, 95% CI = 1.129−1.706, p = 0.002) were independent predictors for PSD at discharge. The cut-off of the fibrinogen plasma level was 3.08 g/L. These predictors were included in the nomogram. The model displayed good discrimination, with a C-index of 0.730 (95% CI = 0.683−0.777) and good calibration. Conclusion: Female gender, baseline stroke severity and a higher level of fibrinogen were independently associated with PSD at discharge. A nomogram based on these three predictors can be used to provide an individual, visual prediction of the risk probability of PSD.

Keywords: fibrinogen; gender; inflammation; post-stroke depression.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow chart. Flow diagram of included and excluded patients.
Figure 2
Figure 2
Receiver operating characteristic (ROC) curve analysis for the plasma level of fibrinogen on admission in predicting Post-stroke depression at discharge.
Figure 3
Figure 3
Nomogram predicting Post-stroke depression of acute ischemic stroke at discharge. NIHSS: National Institutes of Health Stroke Scale.
Figure 4
Figure 4
The calibration curve for predicting Post-stroke depression at discharge. NIHSS: National Institutes of Health Stroke Scale.
See this image and copyright information in PMC

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