Año: 2025

Stroke Survivors Have Almost Three Times Higher Risk of Depression: A Systematic Review and Meta-Analysis

Aryan Naghedi, Raquel Delgado-Mederos and Cristofol Vives-Bauza. J. Clin. Med. 2025, 14, 8410, Doi: 10.3390/jcm14238410

Background: Post-stroke depression (PSD) is one of the most frequent and important complications following stroke that adversely affects conditions such as functional recovery and the patient’s quality of life. Meanwhile, the prevalence proportion of PSD has been widely documented, ranging from 20 to 60%; the relationship between stroke and the manifestation of PSD, quantified with the odds ratio (OR), has been less explored. The primary aim of this meta-analysis is to determine the prevalence OR of suffering depression in stroke survivors. The prevalence proportion of PSD was also analyzed as a secondary aim.

Methods: A pre-registered meta-analysis designed based on PRISMA guidelines with searches from inception to 23 September 2024 was carried out on PubMed, Web of Science, and SCOPUS databases. Studies reporting the prevalence OR associated with PSD manifestation were eligible for inclusion to achieve the primary aim. Twenty-six comparative studies, including a total population of 947,853 people, met the inclusion criteria. PSD prevalence proportion was extracted from 245 articles, including 493,681 stroke patients. Quality assessments were performed using the Newcastle–Ottawa Scale (NOS). Data were meta-analyzed using a random-effects model.

Results: Compared with the control population, stroke survivors had higher odds of developing PSD (OR: 2.71; 95% CI: [2.29–3.22]). Prevalence of PSD was 34.46 ± 16.48. Conclusions: Stroke survivors have almost 3 times higher probability of suffering depression after stroke than the general population, and almost one third of stroke patients will suffer PSD.

Funding: This research was funded by Instituto de Salud Carlos III (ISCIII) through the RICORSICTUS network, grant number [RD24/0009/0022]. The APC was funded by the Liberi Program of the Health Research Institute of Balearic Islands (IdISBa). AN was funded by the FPU fellowship (FPU2024-011-A) granted by General Direction of of Universities, Research and Higher Artistic Education, Balearic Government, co-funded by European Union ERDF.

Minimally invasive evacuation for spontaneous supratentorial haemorrhage: scoping for candidates and hypothetical logistic burdens in a pragmatic scenario

Mosteiro A, Coronel-Coronel M, Pedrosa L et al. Neurosurg Rev. 2025 Sep 27;48(1):669. doi: 10.1007/s10143-025-03823-4.

https://pubmed.ncbi.nlm.nih.gov/41014383/

Abstract: Minimally invasive surgery (MIS) is being evaluated as a promising treatment for spontaneous intracerebral haemorrhage (ICH). Transitioning to early clot removal requires accurate estimation of eligible candidates in practical scenarios. We conducted a prospective population-based observational study of ICH across all public stroke centres in Catalonia-Spain, between 2020 and 2022. Patient characteristics, need for conventional surgery and clinical outcomes were recorded. Inclusion and exclusion criteria from major trials assessing MIS for ICH were retrospectively applied to obtain the number of potential candidates. Sensitivity analyses examined the impact of withdrawal of care (WoC) decisions and variations in
selection criteria on eligibility estimates. Among 2,197 reported ICH cases, 1,571 met the selection criteria and had complete follow-up to be analysed. Annually, 113 (14.4%) patients met the criteria for catheter plus thrombolysis evacuation
(MISTIE-III criteria), and 45 (5.7%) for parafascicular evacuation (ENRICH criteria). Eligibility rates varied considerably depending on age and haematoma volume thresholds, and with changes in WoC, which affected 20–29% of potential candidates.
Conventional evacuation was performed as a life-saving measure in 40 (5%) patients annually according to local protocols. If implemented, MIS protocols could increase the number of clot evacuation procedures in a range of 1.1–1.8 times. In a hypothetical scenario of MIS implementation for early ICH evacuation protocol in Catalonia, 5.7–14.4% of patients could potentially qualify for surgery. Consequently, the annual number of emergent clot evacuation procedures might increase 1.1-fold to 1.8-fold, highlighting substantial impact on healthcare infrastructure and resource planning.

Funding: The HIC-CAT registry was supported by the Instituto de Salud Carlos III (ISCIII) through the RICORS-ICTUS network (RD24/0009/0010). The study was also founded by the European Union program FEDER, and the European Regional Development Fund (ERDF) (PI22/0105).