Resilience is an independent correlate of the course of quality of life in patients with first-ever ischemic stroke

2020 ◽  
pp. 1-9
Author(s):  
Zhihui Liu ◽  
Xuan Zhou ◽  
Wei Zhang ◽  
Lanshu Zhou
Keyword(s):  
Quality Of Life ◽  
Ischemic Stroke ◽  
Multilevel Model ◽  
Depression Scale ◽  
Neurological Function ◽  
Stroke Severity ◽  
Stroke Patients ◽  
Hospitalization Period ◽  
Prospective Longitudinal

ABSTRACT Objectives: To explore the changes in quality of life from the acute hospitalization period to 6 months after discharge in patients with first-ever ischemic stroke and to identify the association between resilience and the course of quality of life. Design: A prospective longitudinal cohort study. Setting: This study was conducted in Shanghai, China. Participants: Two hundred and seventeen stroke patients were recruited for an initial questionnaire survey from two tertiary hospitals from February 2017 to January 2018. Intervention: None. Measurements: Quality of life was measured using the Stroke Scale Quality of Life. Resilience was assessed using the Connor–Davidson Resilience Scale. Other validated measurement instruments included the modified Rankin Scale and Hospital Anxiety and Depression Scale. A multilevel model was used for the analysis of repeated measurements and to determine the association between resilience and quality of life. Results: Quality of life scores significantly improved over the 6 months after discharge (B = 7.31, p < .0001). The multilevel model indicated that resilience was positively correlated with the course of quality of life (B = .133, p < .0001), independent of stroke severity (B = −.051, p = .0006), neurological function (B = −.577, p < .0001), hospitalization days (B = .023, p = .0099), anxiety (B = −.100, p =< .0001), depression (B = −.149, p < .0001), time (B = .360, p < .0001), and the interactions of time with hospitalization days (B = −.008, p = .0002), neurological function (B = .021, p < .0024), depression (B = −.014, p = .0273), and time (B = −.031, p < .0001). Conclusions: Resilience played an important role in predicting the self-reported course of quality of life in stroke patients. Our findings emphasized the reasonableness and importance of developing suitable resilience-targeted clinical strategies for improving prognosis in stroke patients.

scholarly journals Fatigue Impact Scale Demonstrates Greater Fatigue in Younger Stroke Survivors

2012 ◽  
Vol 39 (5) ◽  
pp. 619-625 ◽  
Author(s):  
Natalie E. Parks ◽  
Gail A. Eskes ◽  
Gordon J. Gubitz ◽  
Yvette Reidy ◽  
Christine Christian ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Ischemic Stroke ◽  
Stroke Severity ◽  
Stroke Patients ◽  
Younger Patients ◽  
Post Stroke ◽  
Impact Scale ◽  
Fatigue Impact Scale ◽  
One Year

Background:Fatigue affects 33-77% of stroke survivors. There is no consensus concerning risk factors for fatigue post-stroke, perhaps reflecting the multifaceted nature of fatigue. We characterized post-stroke fatigue using the Fatigue Impact Scale (FIS), a validated questionnaire capturing physical, cognitive, and psychosocial aspects of fatigue.Methods:The Stroke Outcomes Study (SOS) prospectively enrolled ischemic stroke patients from 2001-2002. Measures collected included basic demographics, pre-morbid function (Oxford Handicap Scale, OHS), stroke severity (Stroke Severity Scale, SSS), stroke subtype (Oxfordshire Community Stroke Project Classification, OCSP), and discharge function (OHS; Barthel Index, BI). An interview was performed at 12 months evaluating function (BI; Modified Rankin Score, mRS), quality of life (Reintegration into Normal living Scale, RNL), depression (Geriatric Depression Scale, GDS), and fatigue (FIS).Results:We enrolled 522 ischemic stroke patients and 228 (57.6%) survivors completed one-year follow-up. In total, 36.8% endorsed fatigue (59.5% rated one of worst post-stroke symptoms). Linear regression demonstrated younger age was associated with increased fatigue frequency (β=-0.20;p=0.01), duration (β=-0.22;p<0.01), and disability (β=-0.24;p<0.01). Younger patients were more likely to describe fatigue as one of the worst symptoms post-stroke (β=-0.24;p=0.001). Younger patients experienced greater impact on cognitive (β=-0.27;p<0.05) and psychosocial (β=-0.27;p<0.05) function due to fatigue. Fatigue was correlated with depressive symptoms and diminished quality of life. Fatigue occurred without depression as 49.0% of respondents with fatigue as one of their worst symptoms did not have an elevated GDS.Conclusions:Age was the only consistent predictor of fatigue severity at one year. Younger participants experienced increased cognitive and psychosocial fatigue.

scholarly journals Coping Strategies, Quality of Life, and Neurological Outcome in Patients Treated with Mechanical Thrombectomy after an Acute Ischemic Stroke

2020 ◽  
Vol 17 (17) ◽  
pp. 6014
Author(s):  
Silvia Reverté-Villarroya ◽  
Antoni Dávalos ◽  
Sílvia Font-Mayolas ◽  
Marta Berenguer-Poblet ◽  
Esther Sauras-Colón ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Ischemic Stroke ◽  
Coping Strategies ◽  
Acute Ischemic Stroke ◽  
Functional Outcomes ◽  
Stroke Patients ◽  
Brief Cope ◽  
Best Medical Treatment ◽  
Prospective Longitudinal

New reperfusion therapies have improved the clinical recovery rates of acute ischemic stroke patients (AISP), but it is not known whether other factors, such as the ability to cope, might also have an effect. The aim of this study was to evaluate the effect of endovascular treatment (EVT) on coping strategies, quality of life, and neurological and functional outcomes in AISP at 3 months and 1 year post-stroke. A multicenter, prospective, longitudinal, and comparative study of a sub-study of the participants in the Endovascular Revascularization with Solitaire Device versus Best Medical Therapy in Anterior Circulation Stroke within 8 Hours (REVASCAT) clinical trial was conducted after recruiting from two stroke centers in Catalonia, Spain. The cohort consisted of 82 ischemic stroke patients (n = 42 undergoing EVT and n = 40 undergoing standard best medical treatment (BMT) as a control group), enrolled between 2013–2015. We assessed the coping strategies using the Brief Coping Questionnaire (Brief-COPE-28), the health-related quality of life (HRQoL) with the EQ-5D questionnaire, and the neurological and functional status using the National Institute of Health Stroke Scale (NIHSS), Barthel Index (BI), modified Rankin Scale (mRS), and Stroke Impact Scale-16 (SIS-16). Bivariate analyses and multivariate linear regression models were used. EVT patients were the ones that showed better neurological and functional outcomes, and more patients presented reporting no pain/discomfort at 3 months; paradoxically, problem-focused coping strategies were found to be significantly higher in patients treated with BMT at 1 year.

Abstract 2472: The Negative Impact of Spasticity on the Health-Related Quality of Life of Stroke Survivors

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Patrick Gillard ◽  
Heidi Sucharew ◽  
Sepideh Varon ◽  
Kathleen Alwell ◽  
Charles Moomaw ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Ischemic Stroke ◽  
Negative Impact ◽  
Stroke Severity ◽  
Stroke Survivors ◽  
Health Related Quality ◽  
Stroke Patients ◽  
Related Quality ◽  
Health Related

Background: Spasticity can lead to numerous symptomatic and functional problems that can cause substantial disability. No published studies have quantified the independent effect spasticity has on the health-related quality of life (HRQoL) of stroke survivors. Objective: To assess the hypothesis that spasticity has a negative impact on HRQoL among stroke survivors. Design: In 2005, as part of the Greater Cincinnati/Northern Kentucky Stroke Study, a cohort of 460 ischemic stroke patients were interviewed during hospitalization and then followed over time. Detailed in-person interviews and medical record abstractions were undertaken during the early post-stroke period to capture key information about demographics; pre-stroke level of functioning; social, family, and medical histories; medications; laboratory results; and stroke severity. Follow-up interviews at 3 months, 1 year, and 2 years gathered information on HRQoL as measured by the Short Form-12 (SF-12), EuroQol-5D (EQ-5D), and Stroke Specific Quality of Life (SSQOL). SF-12 scores are divided into mental (MCS) and physical (PCS) components that range from 0 to 100, with higher scores indicating better health. EQ-5D scores range from 0 (death) to 1 (perfect health). SSQOL scores are stroke specific and range between 0 and 5, with lower scores indicating better HRQoL. HRQoL differences between stroke survivors with and without spasticity (as reported by the patient) were cross-sectionally compared using generalized linear models, adjusting for age, race, stroke severity, pre-stroke function, and comorbidities. Results: Of the 460 ischemic stroke patients, 328 had spasticity data available at the 3-month interview, with 54 (16%) reporting spasticity following their stroke. The patients included in the 3-month analysis had a mean age of 66 years; 49% were female, and 26% black. Patients who reported spasticity at 3 months had lower mean PCS, EQ-5D index, and SSQOL total score compared with patients without spasticity ( Table ). Similar differences in HRQoL were also observed at year 1 and year 2 (data not shown). Conclusions: We found statistically and clinically meaningful differences in HRQoL between stroke survivors with and without spasticity at 3 months, 1 year, and 2 years following stroke. Clinically, these results suggest an opportunity to improve HRQoL among stroke survivors with effective spasticity management.

Abstract NS13: Road to Recovery after Stroke: Understanding Predictors of Discharge Destination, Functional Independence, and Quality of Life after Hospital Discharge

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Laurie Paletz ◽  
Pamela Roberts ◽  
Harriet Aronow ◽  
Sonia Guerra ◽  
Tingjian Yan
Keyword(s):  
Quality Of Life ◽  
Comparative Effectiveness ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Stroke Severity ◽  
Stroke Patients ◽  
Functional Scores ◽  
Brain Involvement

Introduction: Stroke is the leading cause of long-term disability and affects 795,000 people in the U.S. each year. This study was conducted to enhance knowledge of outcomes during recovery and the options for participating in rehabilitation and preventive care during patients’ transitions to the community. Comprehensive Stroke Certification charges hospitals with the task of expanding knowledge of functional and quality of life outcomes for all stroke patients through the continuum examining effects of stroke severity, functional impairment, and patient characteristics on discharge destinations, functional independence, and quality of life after discharge. Methods: Retrospective analysis of an acute stroke quality improvement database which includes measures collected by MedTel Outcomes LLC on all stroke patients one month after discharge. Included, is the Functional Independence Measure and standardized quality of life and participation measures. In the database are standardized measures from the medical record such stroke type, Modified Rankin score, and acute functional independence measure score for 719 patients with a 30-day follow-up phone assessment for functional and quality of life measures from January 1, 2011 to December 31, 2012. Preliminary Findings: Over 75% of patients had hemiparesis, & over 90% survived 30-days post discharge and were living in the community. At follow-up, mostwere independent in self-care, and half were independent in mobility excluding stairs. Those with right brain involvement had a complicated, slower recovery. Those with left brain involvement,had lower functional scores and a higher percentage of them were not living in the community, rather, living in institutions. Conclusions: All patients experiencing a stroke should have evidence-based information on their options & what to expect during their recovery during their transitions into the community. The data base is useful as a source of outcome data for comparative effectiveness and to build a regional collaborative outcomes database for Comparative Effectiveness Research and quality benchmarking. Findings can be used to understand the functional trajectory of recovery based on severity of stroke and other factors.

scholarly journals Comparison of 3-Month Stroke Disability and Quality of Life across Modified Rankin Scale Categories

2016 ◽  
Vol 6 (1-2) ◽  
pp. 36-41 ◽  
Author(s):  
Srikant Rangaraju ◽  
Diogo Haussen ◽  
Raul G. Nogueira ◽  
Fadi Nahab ◽  
Michael Frankel
Keyword(s):  
Quality Of Life ◽  
Ischemic Stroke ◽  
Functional Disability ◽  
Modified Rankin Scale ◽  
Stroke Patients ◽  
Good Outcome ◽  
Health Related Qol ◽  
Health Related ◽  
Sparse Methods

Background and Purpose: Modified Rankin Scale (mRS) score 0-2 has been used to define “good outcome” while stroke patients with mRS 3 are grouped with mRS 4-6 as having “poor outcome.” Long-term data comparing quality of life (QoL), particularly across the mRS 2, 3, and 4 subgroups, are sparse. Methods: Participants in the Interventional Management of Stroke 3 (IMS3) trial with documented 3-month mRS, functional disability (Barthel index [BI]), and self-reported EQ5D-3L QoL questionnaires at 3 months after stroke were included. EQ5D-3L summary indices were calculated using published utility weights for the US population. BI and EQ5D-3L indices were compared across mRS categories using multiple pairwise comparisons with appropriate alpha error corrections. Results: Four hundred twenty-three patients were included (mean age 64 ± 13 years, median baseline NIHSS 16 [IQR 12-19], mean BI 84.1 ± 25.3, and mean EQ5D-3L index 0.73 ± 0.24). While significant differences in BI were observed across mRS categories, QoL in the mRS 2 and 3 categories was similar. Based on BI and EQ5D-3L index, mRS 3 status was more similar to mRS 2 than to mRS 4 status, and large heterogeneity in the mRS 3 group was observed. Conclusions: Ischemic stroke patients who achieve mRS 2 and 3 functional outcomes seem to have similar health-related QoL scores. mRS 0-3, rather than 0-2, should be considered a good outcome category in moderate to severe ischemic stroke.

Influence of depression on the quality of life after stroke

2017 ◽  
Vol 41 (S1) ◽  
pp. S475-S475
Author(s):  
E. Kostadinova ◽  
A. Anita
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Negative Impact ◽  
Depression Scale ◽  
Hamilton Depression Scale ◽  
Stroke Patients ◽  
Sf 36 ◽  
Degree Of Disability ◽  
Associated Risk Factors

AimApproximately 30–60% of the stroke survivors suffers from depression. This, together with the physical changes after stroke may lead to a decline in their quality of life (QOL). The aim of this paper was to analyse the incidence of post-stroke depression, associated risk factors and its influence on the QOL.Material and methodsWe carried out a prospective study on stroke patients during a period of 6months. We excluded patients with dysphasia and aphasia. For each patient, we collected socio-demographic characteristics as well as clinical and therapeutic data. We used the Hamilton Depression Scale to screen for anxiety and depression, the SF-36 scale to assess the quality of life and modified Rankin scale (mRS) to measure the degree of disability.ResultsWe included 155 men and 143 women with stroke, with mean age of 58.15 years. Out of 298 analysed patients, depression was present in 147 (49.3%). Associated risk factors were hypertension, female gender and severity of stroke (P < 0.05). The mean score of the SF-36 was 52.18. Impaired QOL was found in 221 (74.1%) and mRS > 3 was found in 169 (57.1%) of the patients. Impaired mental component of QOL significantly correlated with the presence of depression (P < 0.05) and anxiety (P < 0.05). The severe degree of disability had a significant negative impact on all areas of QOL.ConclusionImportant effect after stroke is occurrence of depression which affects the QOL and functional outcome. All stroke patients should be evaluated for depression through regular interviews with them and their families or caregivers. Adequate antidepressant treatment should be given, in order to improve the QOL and physical rehabilitation.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Efficacy of sovateltide (IRL-1620) in a multicenter randomized controlled clinical trial in patients with acute cerebral ischemic stroke

2020 ◽  
Author(s):  
Anil Gulati ◽  
Nilesh Agrawal ◽  
Deepti Vibha ◽  
U.K. Misra ◽  
Birinder Paul ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Ischemic Stroke ◽  
Odds Ratio ◽  
Controlled Study ◽  
Stroke Patients ◽  
Neurological Outcomes ◽  
Number Of Patients ◽  
Cerebral Ischemic Stroke ◽  
Cerebral Ischemic

Background: Sovateltide (IRL-1620, PMZ-1620), an endothelin-B receptor agonist, administered intravenously following acute cerebral ischemic stroke increased cerebral blood flow, had anti-apoptotic activity and produced neurovascular remodeling. Its safety and tolerability were confirmed in healthy human volunteers (CTRI/2016/11/007509). Objective: To determine safety, tolerability and efficacy of sovateltide as an adjuvant to standard of care (SOC) in acute cerebral ischemic stroke patients. Methods: A prospective, multi-centric, randomized, double-blind, controlled study to compare efficacy of sovateltide in patients with acute cerebral ischemic stroke was conducted in 40 patients, of which 36 completed 90-day follow-up. Patients who had stroke within the last 24 hours with a radiologic confirmation of ischemic stroke were included in the study. Patients with intracranial hemorrhage and those receiving endovascular therapy were excluded. All patients in both groups received SOC for stroke. Patients randomized in the sovateltide group received three doses of sovateltide (each dose 0.3 μg/kg) administered as an IV bolus over 1 minute at an interval of 3 hours ± 1 hour on day 1, day 3 and day 6 (total dose of 0.9 μg/kg/day). Patients randomized in the placebo group received equal volume of saline. Efficacy was evaluated by neurological outcomes based on National Institute of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS) and Barthel Index (BI) scales. Quality of Life was measured by EuroQoL (EQ-5D) and stroke specific quality-of-life (SS-QoL). Results: Patients received saline (n=18; 11 male and 7 female) or sovateltide (n=18; 15 male and 3 female) within 24 hours of onset of stroke. Number of patients receiving investigational drug within 20 hours of onset of stroke were 14/18 in saline and 10/18 in sovateltide cohorts. The baseline characteristics and SOC in both cohorts was similar. Sovateltide treatment resulted in a significantly quicker recovery as measured by improvements in neurological outcomes in mRS and BI scales on day 6 compared to day 1 (p<0.0001). Moreover, sovateltide increased the frequency of favorable outcomes in all scales at 3 months. An improvement of ≥2 points in mRS was observed in 60% and 40% patients in sovateltide and saline groups, respectively (p=0.0519; odds ratio 5.25). BI improvement of ≥40 points was 64% and 36% in sovateltide and saline groups, respectively (p=0.0112; odds ratio 12.44). An improvement of ≥6 points was seen in NIHSS in 56% of patients in sovateltide vs 43% in saline groups (p=0.2714; odds ratio 2.275). Number of patients with complete recovery achieving NIHSS score of 0 and BI of 100 were significantly more (p<0.05) in sovateltide group compared to saline group. Sovateltide treatment resulted in improved Quality of Life as measured by EuroQoL and SS-QoL (stroke specific quality-of-life) on day 90. Sovateltide was well tolerated and all patients received complete treatment with no incidence of drug related adverse event reported. Hemodynamic, biochemical or hematological parameters were not affected with sovateltide. Conclusion: Sovateltide was safe, well tolerated, and resulted in quicker recovery and improved neurological outcome in acute cerebral ischemic stroke patients 90 days post-treatment.

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