TY  - JOUR
PY  - 2023//
TI  - Prevalence and outcomes of depression, obstructive sleep apnea, and concurrent anxiety (DOCA) in stroke survivors: insights from a nationwide study
JO  - Curēus
A1  - Patel, Urvish K.
A1  - Rao, Alankruta
A1  - Manihani, Gurpal Singh D.
A1  - Patel, Neel
A1  - George, Cilgy
A1  - Vijayakumar, Jai Sriram
A1  - Evangeline, Sekharamahanti H.
A1  - Alam, Mohammad R.
A1  - Ghuman, Kulbir
A1  - Francis, Stephan Z.
A1  - Pandya, Ishani
A1  - Reddy, Chandrakanth
A1  - Parikh, Tapan
A1  - Shah, Shamik
SP  - e41968
EP  - e41968
VL  - 15
IS  - 7
N2  - BACKGROUND: Many individuals will also experience psychological side effects after a stroke episode, such as symptoms of depression, anxiety (generalized anxiety disorder (GAD)), and/or specific phobias, considerably decreasing their quality of life (QOL). <br><br>OBJECTIVE: This study aimed to evaluate the prevalence of depression, obstructive sleep apnea (OSA), and concurrent anxiety (DOCA) and their outcomes (morbidity, disability (All Patient Refined Diagnosis Related Group (APRDRG) - loss of function), and discharge disposition) among acute ischemic stroke (AIS) hospitalizations. <br><br>METHODS: A cross-sectional study used the National Inpatient Sample (NIS) from 2003-2017. Adults with hospitalizations with AIS were extracted, and DOCA was identified using ICD-9/10-CM codes. Weighted analysis using a chi-square test and mixed-effect multivariable survey logistic regression was used to assess the prevalence and role of DOCA in predicting outcomes. <br><br>RESULTS: Out of 5,690,773 AIS hospitalizations, 2.7%, 3.1%, and 4.4% had depression, OSA, and GAD, respectively. In AIS patients, females had a higher prevalence of depression (3.4% vs. 2.3%) and GAD (5.9% vs. 3.0%) and a quality of life lower prevalence of OSA (2.2% vs 4.4%) in comparison to males (p<0.0001). Caucasians had a higher prevalence of depression, OSA, and GAD in comparison to others (African Americans/Hispanics/Asians/Native Americans). Depressed patients had a higher prevalence of morbidity (9% vs. 8% vs 5% vs. 7%), disability (46% vs. 46% vs. 35% vs. 37%), transfer to non-home (69% vs. 58% vs. 61% vs. 63%) in comparison with OSA, GAD, and non-DOCA patients, respectively (p<0.0001). Depression was associated with a 40% higher chance of severe disability (aOR 1.40; 95% CI 1.38-41), morbidity (1.36; 1.33-1.38), and discharge to non-home (1.54; 1.52-1.56). OSA and GAD had higher odds of non-home discharge amongst post-AIS hospitalizations. <br><br>CONCLUSION: DOCA is associated with poor outcomes among post-AIS patients. Prompt recognition by screening and timely management of DOCA may mitigate the adverse outcomes.<p />  <p>Language: en</p>
LA  - en
SN  - 2168-8184
UR  - http://dx.doi.org/10.7759/cureus.41968
ID  - ref1
ER  -