AUTHOR=Lu Jieyi , Zhang Lulu , Zhang Yi , Mao Huawu , Fang Qi 

TITLE=Intravenous thrombolysis and risk of early-onset post-stroke depression: a propensity score matched cohort study

JOURNAL=Frontiers in Neurology

VOLUME=Volume 15 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2024.1385266

DOI=10.3389/fneur.2024.1385266

ISSN=1664-2295

ABSTRACT=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.