Serum prealbumin at admission is associated with post-stroke depression at 3 months in patients with spontaneous intracerebral hemorrhage.

BACKGROUND: Post-stroke depression (PSD) represents a frequent neuropsychiatric condition in patients with spontaneous intracerebral hemorrhage (sICH) and is associated with impaired functional rehabilitation and diminished quality of life. Clarifying biological factors associated with subsequent PSD may improve the understanding of psychological vulnerability after sICH. Serum prealbumin, a negative acute-phase protein that may reflect acute inflammatory and nutritional-metabolic status, has been associated with adverse stroke outcomes, but its relationship with PSD remains unclear. This study aimed to investigate the association between serum prealbumin at admission and PSD at 3 months post-stroke. METHODS: A retrospective cohort study was conducted on 446 patients with sICH. Serum prealbumin at admission was defined as the first available measurement obtained within 48 hours after hospital admission. PSD was defined as a diagnosis of depression at 3 months post-stroke, based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria and a 17-item Hamilton Depression Rating Scale (HAMD-17) score of ≥8. The association between serum prealbumin and PSD was assessed through multivariable logistic regression analysis. RESULTS: In total, 159 patients (35.7%) were diagnosed with PSD. Serum prealbumin levels were reduced in patients with PSD compared with those without PSD (223.7 ± 52.8 vs. 243.4 ± 53.6 mg/L, P < 0.001). Patients in the third and fourth quartiles of serum prealbumin had significantly lower odds of PSD. Higher admission serum prealbumin was independently associated with lower odds of PSD after multivariable adjustment. CONCLUSIONS: Lower admission serum prealbumin was independently associated with higher odds of PSD at 3 months among patients with sICH who completed follow-up assessment. Serum prealbumin may represent a nonspecific peripheral marker reflecting acute inflammatory and nutritional-metabolic status after sICH.