Background

There is relatively limited information on the risk factors and outcome of new onset Poststroke Anxiety (PSA) in Low- and Middle-Income Countries. We estimated incidence, cumulative incidence, risk factors and outcome of new onset anxiety in the first year of stroke among African stroke survivors.

Methods

We analyzed the dataset of a completed clinical trial comprising patients enrolled to test an intervention designed to improve one-year blood pressure control among recent (≤ one month) stroke survivors in Nigeria. Anxiety was measured using the Hospital Anxiety and Depression Scale. Outcomes were assessed using the modified Rankin Scale (mRS), Community screening instrument for dementia (CSID) and Health Related Quality of Life in Stroke Patients (HRQOLISP-26).

Results

Among 322 stroke survivors who were free of anxiety at baseline, we found a one-year cumulative incidence of 34% (95% CI = 28.6–39.3). Rates were 36.2% (95% CI =29.6–42.7) for men and 29.2% (95% CI =19.9–38.3) for women. In multivariate Cox regression analyses, haemorrhagic stroke type was associated with higher risk of new onset PSA (Hazard Ratio=1.52, 95% CI =1.01–2.29). New onset PSA was independently associated with cognitive [(mean difference (MD) in CSID scores=1.1, 95% C.I=0.2, 1.9)] and motor decline (MD in mRS scores= −0.2, 95% C.I= −0.4, −0.02), as well as poorer quality of life overtime (MD in total HRQOLISP-26 scores=3.6, 95% C.I=1.0, 6.2).

Conclusion

One in 3 stroke survivors in Nigeria had PSA at one year. Clinicians in SSA should pay special attention to survivors of haemorrhagic stroke as they are at higher risk of incident anxiety and therefore its consequences.

中文翻译：

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非洲黑人一年内新发中风后焦虑的预测因素和预后。

背景

关于中低收入国家新发卒中后焦虑 (PSA) 的风险因素和结果的信息相对有限。我们估计了非洲中风幸存者中风第一年新发焦虑的发病率、累积发病率、危险因素和结果。

方法

我们分析了一项已完成的临床试验的数据集，该试验包括参加测试旨在改善尼日利亚近期（≤ 1 个月）中风幸存者一年血压控制的干预措施的患者。使用医院焦虑和抑郁量表测量焦虑。使用改良的 Rankin 量表 (mRS)、痴呆症社区筛查工具 (CSID) 和中风患者的健康相关生活质量 (HRQOLISP-26) 评估结果。

结果

在基线时没有焦虑的 322 名卒中幸存者中，我们发现一年累积发生率为 34%（95% CI = 28.6-39.3）。男性为 36.2%（95% CI =29.6-42.7），女性为 29.2%（95% CI =19.9-38.3）。在多变量 Cox 回归分析中，出血性卒中类型与新发 PSA 的风险较高相关（危险比 = 1.52，95% CI = 1.01–2.29）。新发 PSA 与认知能力 [（CSID 评分的平均差异 (MD)=1.1, 95% CI=0.2, 1.9)] 和运动能力下降（mRS 评分的 MD= -0.2, 95% CI= -0.4, - 0.02），以及更差的生活质量（HRQOLISP-26 总分中的 MD=3.6，95% CI=1.0，6.2）。

结论

尼日利亚三分之一的中风幸存者在一年内患有 PSA。SSA 的临床医生应特别注意出血性中风的幸存者，因为他们发生焦虑事件的风险更高，因此其后果也更高。