Depression impacts discharge destination after stroke

NEW YORK (Reuters Health) - Patients with depression at the time they are hospitalized for a stroke are more likely to be discharged to institutional care than their non-depressed counterparts, results of a study hint.

In the study, researchers looked at the impact of having depression at the time of hospital admission for stroke on time spent in the hospital and discharge destination. The study included 41 patients with pre-existing depression, 62 with another mental illness, and 211 patients without mental illness.

Having pre-existing depression or another pre-existing mental condition did not significantly influence time spent in the hospital or the risk of death, Jasper Nuyen from Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, and associates report.

However, patients with pre-existing depression faced significantly higher odds of being discharged to an institution than patients without any pre-existing mental health condition. Having another pre-existing mental health condition did not significantly alter the odds of being discharged to an institution.

"It is not possible to deduce whether our finding that pre-existing depression is a potentially important factor in determining discharge destination reflects 'good' or 'bad' clinical practice," Nuyen told Reuters Health.

"Evidently," Nuyen added, "more research is needed. For instance, further studies are required that elucidate the pathway(s) by which depression influences the prognosis of patients who have suffered a stroke and their use of health services."

SOURCE: Stroke, January 2008.