Effect of depressive symptoms on the length of hospital stay among patients hospitalized for acute stroke in Japan

Norio Sugawara,1 Norifumi Metoki,2 Joji Hagii,2 Shin Saito,2 Hiroshi Shiroto,2 Tetsu Tomita,1 Minoru Yasujima,2 Ken Okumura,3 Norio Yasui-Furukori1 1Department of Neuropsychiatry, Hirosaki University School of Medicine, Hirosaki, Japan; 2Hirosaki Stroke and Rehabilitation Center, Hirosaki, Japan; 3Department of Cardiology, Hirosaki University School of Medicine, Hirosaki, Japan Background: Depression after stroke is one of the most serious complications of stroke. Although many studies have shown that the length of hospital stay (LOHS) is a measurable and important stroke outcome, research has found limited evidence concerning the effect of depression on LOHS among patients who have experienced acute stroke. The objective of this study was to assess the effect of depression on LOHS among patients hospitalized for acute ischemic stroke in Japan. Methods: We retrospectively examined 421 patients who had experienced acute ischemic stroke. Stroke severity was measured by the National Institutes of Health Stroke Scale (NIHSS) on the 7th day of hospitalization. On the 10th day of hospitalization, depressive symptoms and functional assessment were assessed by the Japan Stroke Scale (Depression Scale) and the Functional Independence Measure, respectively. A general linear model was employed to assess the effect of probable depression on LOHS. Results: The prevalence of probable depression in the current sample was 16.3% in males and 17.8% in females. The mean LOHS of participants with probable depression (76.4±49.2 days) was significantly longer than that of participants without probable depression (44.9±39.2 days). An analysis using the general linear model to assess the effect on LOHS revealed a significant interaction between the presence of probable depression and NIHSS scores. Conclusion: Depression after stroke was associated with significant increases in LOHS. Early detection and treatment for depression are necessary for patients with ischemic stroke. Keywords: poststroke depression, length of hospital stay, ischemic stroke, Japanese