Background and Purpose: Rates of depression after ischemic stroke (IS) and myocardial infarction (MI) are significantly higher than in the general population and associated with morbidity and mortality. There is a lack of nationally representative data comparing depression and suicide attempt (SA) after these distinct ischemic vascular events. Methods: The 2013 Nationwide Readmissions Database contains #x3e;14 million US admissions for all payers and the uninsured. Using International Classification of Disease, 9th Revision, Clinical Modification Codes, we identified index admission with IS (n = 434,495) or MI (n = 539,550) and readmission for depression or SA. We calculated weighted frequencies of readmission. We performed adjusted Cox regression to calculate hazard ratio (HR) for readmission for depression and SA up to 1 year following IS versus MI. Analyses were stratified by discharge home versus elsewhere. Results: Weighted depression readmission rates were higher at 30, 60, and 90 days in patients with IS versus MI (0.04%, 0.09%, 0.12% vs. 0.03%, 0.05%, 0.07%, respectively). There was no significant difference in SA readmissions between groups. The adjusted HR for readmission due to depression was 1.49 for IS versus MI (95% CI 1.25–1.79, p #x3c; 0.0001). History of depression (HR 3.70 [3.07–4.46]), alcoholism (2.04 [1.34–3.09]), and smoking (1.38 [1.15–1.64]) were associated with increased risk of depression readmission. Age #x3e;70 years (0.46 [0.37–0.56]) and discharge home (0.69 [0.57–0.83]) were associated with reduced hazards of readmission due to depression. Conclusions: IS was associated with greater hazard of readmission due to depression compared to MI. Patients with a history of depression, smoking, and alcoholism were more likely to be readmitted with depression, while advanced age and discharge home were protective. It is unclear to what extent differences in type of ischemic tissue damage and disability contribute, and further investigation is warranted.
Cerebrovasc Dis Extra 2020;10:94–104

中文翻译：

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中风和心肌梗塞后因抑郁和自杀未遂而再次入院。

背景与目的：缺血性中风（IS）和心肌梗塞（MI）后的抑郁症发生率明显高于一般人群，并且与发病率和死亡率相关。在这些明显的缺血性血管事件后，缺乏比较抑郁和自杀未遂（SA）的全国代表性数据。方法： 2013年全国再入学数据库包含＃x3e；所有付款人和未投保人的1400万份美国入学记录。使用《国际疾病分类》（第9版），《临床修改规范》，我们以IS（ n = 434,495）或MI（ n= 539,550），并因抑郁症或SA重新入院。我们计算了再入院的加权频率。我们进行了调整后的Cox回归，以计算IS与MI之间长达1年的抑郁和SA再入院的危险比（HR）。分析按出院与其他地方进行分层。结果： IS患者与MI患者在30、60和90天时加权抑郁的再入院率较高（分别为0.04％，0.09％，0.12％和0.03％，0.05％，0.07％）。两组之间的SA再入院率无显着差异。IS相对于MI的因抑郁而重新入院的调整后HR为1.49（95％CI 1.25–1.79，p＃x3c; 0.0001）。抑郁史（HR 3.70 [3.07–4.46]），酗酒（2.04 [1.34–3.09]）和吸烟（1.38 [1.15-1.64]）与抑郁症再次入院的风险增加相关。年龄＃x3e； 70岁（0.46 [0.37-0.56]）和出院（0.69 [0.57-0.83]）与因抑郁症而再次入院的风险降低相关。结论：与MI相比，IS与抑郁症相关的再入院风险更大。有抑郁，吸烟和酒精中毒史的患者更容易因抑郁而重新入院，而高龄和出院则具有保护作用。目前尚不清楚缺血性组织损伤和残疾类型的差异在多大程度上造成了影响，有待进一步研究。
Cerebrovasc Dis Extra 2020; 10：94–104