Risk factors and prediction model for depressive disorder in survivors of acute cerebral hemorrhage

Table 1 Comparison of baseline data, n (%)/mean ± SD/medians (interquartile range)

Grouping1	Depression group (n = 90)	Non-depressed group (n = 109)	t/χ2	P value
Age (years)	67.18 ± 13.14	61.64 ± 14.84	2.757	0.006
Gender			0.051	0.821
Male	60 (66.67)	71 (65.14)
Female	30 (33.33)	38 (34.86)
Length of hospital stay (days)	31.98 ± 15.25	26.44 ± 14.19	2.649	0.009
History of atrial fibrillation	5 (5.56)	5 (4.59)	0.097	0.756
Medication history
Statins	23 (25.56)	24 (22.02)	0.342	0.559
Anticoagulation	37 (41.11)	46 (42.20)	0.024	0.877
Imaging indicators
Hematoma volume (mL)	88.62 (36.95, 113.80)	73.14 (49.80, 99.11)	2.001	0.045
Hematoma location			8.284	0.040
Lobe	17 (18.89)	35 (32.11)
Deep (basal ganglia/thalamus)	62 (68.89)	58 (53.21)
Infratentorial (cerebellum/brainstem)	9 (10.00)	8 (7.34)
Mixed area	2 (2.22)	8 (7.34)
Break into ventricle	25 (27.78)	35 (32.11)	0.439	0.507
Brain edema	16 (17.78)	20 (18.35)	0.011	0.917
Midline brain shift	36 (40.00)	25 (22.94)	6.753	0.009
Brain atrophy grade			7.916	0.048
0 points	37 (41.11)	65 (59.63)
1 point	29 (32.22)	27 (24.77)
2 points	23 (25.56)	17 (15.60)
3 points	1 (1.11)	0 (0.00)
Subarachnoid hemorrhage	8 (8.89)	15 (13.76)	1.145	0.285
Laboratory indicators
Preprotein (mg/L)	231.48 ± 69.02	241.79 ± 67.04	1.065	0.288
Albumin (g/L)	33.33 (30.36, 35.91)	37.94 (34.88, 41.24)	6.727	< 0.001
Uric acid (μmol/L)	284.17 ± 117.20	289.73 ± 122.50	0.325	0.745
Random blood glucose (mmol/L)	5.57 (4.88, 6.50)	5.43 (4.87, 6.37)	0.579	0.563
Total cholesterol (mmol/L)	4.26 ± 0.95	4.40 ± 0.93	0.981	0.328
Triglycerides (mmol/L)	1.59 ± 0.99	1.76 ± 0.95	1.220	0.224
High-density lipoprotein cholesterol (mmol/L)	1.01 (0.88, 1.21)	1.09 (0.96, 1.25)	2.074	0.038
Low-density lipoprotein cholesterol (mmol/L)	2.68 ± 0.74	2.71 ± 0.68	0.273	0.785
Prothrombin time (seconds)	11.78 ± 1.15	11.84 ± 1.61	0.323	0.747
International normalized ratio	1.04 ± 0.11	1.05 ± 0.15	0.518	0.605
Activated partial thromboplastin time (seconds)	30.63 ± 4.19	30.06 ± 3.55	1.046	0.297
Fibrinogen (g/L)	3.54 ± 1.00	3.47 ± 1.27	0.406	0.685
Related rating scale
Van Swieten score (points)	1.03 (0.00, 2.00)	0.86 (0.00, 1.00)	1.457	0.145
Glasgow Outcome Scale score (points)	4.51 ± 0.72	4.48 ± 0.74	0.326	0.744
Mini-Mental State Examination score (points)	26.58 ± 6.28	25.95 ± 6.44	0.692	0.490
Modified Rankin Scale score (points)	2.77 (2.00, 3.00)	1.85 (1.00, 2.00)	6.160	< 0.001

¹This table compares the baseline characteristics of acute intracerebral hemorrhage survivors in the depression group and non-depression group using appropriate statistical methods. Normally distributed continuous variables (e.g., age, expressed as mean ± SD) were compared by independent-samples t-test; non-normally distributed continuous variables [e.g., hematoma volume, expressed as median (interquartile range)] were compared by Mann-Whitney U test; categorical variables [e.g., gender, expressed as n (%)] were compared by Pearson’s χ² test. The results showed significant differences in age, hematoma volume and other indicators between the two groups (P < 0.05).

Table 2 Univariate logistic regression analysis

Variable1	β	SE	Wald	OR (95%CI)	P value
Age	0.050	0.018	7.950	1.051 (1.015-1.088)	0.005
Length of hospital stay	0.035	0.018	3.780	1.036 (1.000-1.073)	0.052
Hematoma volume	0.606	0.322	3.542	1.833 (0.975-3.446)	0.059
Hematoma location
Lobe			5.854	1	0.119
Deep	1.171	0.543	4.658	3.225 (1.114-9.341)	0.031
Infratentorial	0.883	0.811	1.188	2.419 (0.494-11.847)	0.276
Mixed area	-0.345	1.227	0.079	0.708 (0.064-7.846)	0.778
Midline brain shift	1.040	0.499	4.336	2.828 (1.063-7.524)	0.037
Brain atrophy grade
0 points			3.680	1	0.298
1 point	0.909	0.498	3.328	2.482 (0.935-6.593)	0.068
2 points	0.623	0.571	1.189	1.864 (0.609-5.707)	0.275
3 points	23.400	40192.970	0.000		1.000
Albumin	-0.298	0.054	30.883	0.742 (0.668-0.824)	< 0.001
Modified Rankin Scale score	1.219	0.254	22.982	3.384 (2.056-5.571)	< 0.001

¹This table analyzes the association between each baseline indicator and depression in acute intracerebral hemorrhage survivors by univariate logistic regression. Continuous variables (e.g., albumin) and categorical variables (e.g., hematoma location) were included as independent variables, with “presence of depression” as the dependent variable. For categorical variables, “lobe” (hematoma location) and “0 points” (brain atrophy grade) served as reference groups. The results identified 8 indicators with statistical differences (P < 0.05) for subsequent multivariate analysis.

OR: Odds ratio; CI: Confidence interval.

Table 3 Multivariate logistic regression analysis

Variable1	β	SE	Wald	OR (95%CI)	P value
Age	0.039	0.015	6.812	1.040 (1.010-1.071)	0.009
Deep hematoma	0.850	0.416	4.177	2.340 (1.035-5.288)	0.041
Midline brain shift	1.107	0.444	6.209	3.026 (1.267-7.231)	0.013
Albumin	-0.283	0.049	32.963	0.753 (0.684-0.830)	< 0.001
Modified Rankin Scale score	1.110	0.225	24.286	3.036 (1.952-4.721)	< 0.001

¹This table identifies independent risk factors for depression in acute intracerebral hemorrhage survivors by multivariate logistic regression, with confounding factors (hospitalization time, hematoma volume, brain atrophy grade) controlled. Variables with statistical differences in univariate analysis were included, and “presence of depression” was the dependent variable. The results showed that advanced age, deep hematoma, brain midline shift, low albumin level and elevated modified Rankin Scale score were independent risk factors for depression (P < 0.05).

OR: Odds ratio; CI: Confidence interval.

Table 4 Receiver operating characteristic curve analysis results

Variable1	AUC	Youden index	Optimal cutoff value	Sensitivity (%)	Specificity (%)	95%CI	P value
Age	0.608	0.178	58	75.56	42.20	0.536-0.676	0.007
Deep hematoma	0.578	0.157	1	68.89	46.79	0.507-0.648	0.022
Midline brain shift	0.585	0.171	1	40.00	77.06	0.514-0.655	0.010
Albumin	0.777	0.459	36.23	78.89	66.97	0.713-0.833	< 0.001
Modified Rankin Scale score	0.742	0.398	2	60.00	79.82	0.676-0.801	< 0.001
Combined receiver operating characteristic	0.885	0.603	0.279	93.33	66.97	0.832-0.926	< 0.001

¹This table evaluates the predictive efficacy of individual indicators and the combined model for depression in acute intracerebral hemorrhage survivors by receiver operating characteristic curve analysis. Area under the curve, sensitivity, specificity and 95% confidence interval were calculated to assess discriminatory power. The results showed that the combined model had the highest area under the curve (0.885), with sensitivity of 93.3% and specificity of 67.0%, indicating better predictive efficacy than single indicators (P < 0.001).

AUC: Area under the curve; CI: Confidence interval.