**3. Results**

From 750 patients included into PROPOLIS study 524 filled out the PHQ-9. After three and 12 months after stroke 514 and 487 patients were available for examination, respectively. A flowchart (Figure 1) and a timeline (Figure 2) show the study design.

**Figure 1.** Study flowchart.

**Figure 2.** Study timeline.

When compared to controls, patients with PSD were significantly older, more often females, less often had left hemispheres stroke and treatment with recombinant tissue plasminogen activator (rt-PA), suffered from pneumonia, and had higher C-reactive protein (CRP) levels during hospitalization. Also, they were significantly more physically disabled prior to admission, more often had TIA or stroke in the past and had more comorbidities at baseline comparisons. Early depression was significantly more often accompanied by other neuropsychiatric conditions: apathy, anxiety, delirium, and dementia. Table 1 shows the details.

After three months, 24 patients died, 10 were lost from the follow-up and mRS score was not obtained in 18 patients. After 12 months, 31 persons died, and another 27 patients were lost from the follow-up. Patients who were lost from the follow-up did not differ significantly from those analyzed. Table 2 shows the results.

In the first step, we compared patients with PHQ-9 ≥ 5 points with those who scored 4 or less. After 3 and 12 months after stroke, PSD was an independent risk factor for death in multivariable logistic regression analysis. Also, PSD independently increased the level of disability of 1 point on mRS among patients with PSD three and 12 months post-stroke. Table 3 and Figures 3 and 4 show the final results.

In the second step, we excluded patients with pre-SD from further analyses. The general characteristic of patients with PSD and controls, after exclusion of patients with pre-SD, are shown in Table 4. The final results were very similar to those obtained in first analysis. Only the side of stroke lost its significance.

In regression analyses, PSD was still an independent variable for mortality and increased level of disability measured by mRS three and 12 months after stroke. Table 5 shows the results.

Patients that were lost from the follow-up in this sub-analysis did not differ significantly from analyzed group. Table 6 shows the details.

In the third step, we compared only pre-SD with patients without depression (pre- or post-stroke). Patients with pre-SD were significantly more often women, had more comorbidities and had higher level of disability prior to admission. Table 7 shows the details.

Pre-SD increased the level of disability on mRS of 1 point at threeand 12 months post-stroke and predicted mortality within 12 months after stroke. Table 8 shows the results.

Patients with pre-SD significantly more often had PSD and they also had significantly more severe depression when compared to other individuals. There was no relationship between NIHSS score and PHQ-9 score. Tables 9 and 10 show the results.



\* *n* (%); \*\* median (IQR); TOAST—Trial of Org 10172 in Acute Stroke Treatment; rt-Pa—recombinant tissue plasminogen activator; PCI—percutaneous coronary interventions; CABG—coronary artery bypass graft; TIA—transient ischemic attack; CIRS—Cumulative Illness Rating Scale; AES—Apathy Evaluation Scale; STAI—State-Trait Anxiety Inventory (S—state scale, T—trait scale); NIHSS—National Institutes of Health Stroke Scale; mRS—Modified Rankin Scale; IQCODE—Informant Questionnaire on Cognitive Decline in the Elderly; CRP—C-reactive protein.





**Table**

**3.**

Influence

of

*Biomedicines* **2020** , *8*, 509



\* *n* (%); \*\* median (IQR); TOAST—Trial of Org 10172 in Acute Stroke Treatment; rt-Pa—recombinant tissue plasminogen activator; PCI—percutaneous coronary interventions; CABG—coronary artery bypass graft; TIA—transient ischemic attack; CIRS—Cumulative Illness Rating Scale; AES—Apathy Evaluation Scale; STAI—State-Trait Anxiety Inventory (S—state scale, T—trait scale); NIHSS—National Institutes of Health Stroke Scale; mRS—Modified Rankin Scale; IQCODE—Informant Questionnaire on Cognitive Decline in the Elderly; CRP—C-reactive protein.


*Biomedicines* **2020** , *8*, 509



 *n* (%); median (IQR); CIRS—Cumulative Illness Rating Scale; NIHSS—National Institutes of Health Stroke Scale; mRS—Modified Rankin Scale.



\**n* (%); \*\* median (IQR); TIA—transient ischemic attack; CIRS—Cumulative Illness Rating Scale; NIHSS—National. Institutes of Health Stroke Scale; mRS—Modified Rankin Scale.


**Table 8.** Influence of pre-stroke depression on mortality and disability 3 and 12 months after stroke.

PHQ-9 score \*\*

 516 \* *n* (%); \*\* median (IQR); PHQ-9—The

 9 (6–12)

 Patient Health

 5 (2–9)

Questionnaire-9.

<0.001

#### *Biomedicines* **2020** , *8*, 509

**Table 10.** Correlations between NIHSS and PHQ-9 at the hospital.

**Figure 3.** A pie chart presenting the influence of post-stroke depression on mortality.

**Figure 4.** A pie chart presenting the influence of post-stroke depression on disability.
