Abstract W MP105: Long Term Stroke Outcome and Caregiving Among Mexican Americans (MA) and Non-Hispanic Whites (NHW): The Population-Based Brain Attack Surveillance in Corpus Christi (BASIC) Study

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Brisa N Sanchez ◽  
Lynda Lisabeth ◽  
Darin Zahuranec ◽  
Melinda A Cox ◽  
Nelda Garcia ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Repeated Measures ◽  
Mexican Americans ◽  
Caregiver Strain ◽  
Stroke Survivors ◽  
Basic Study ◽  
Long Term Outcome ◽  
Post Stroke

Background: Long term stroke outcomes in MA are understudied, and the role of informal caregiving and caregiver strain in this population is unknown. We report a pilot study of long-term outcomes in BASIC. Methods: Patients previously interviewed at 90 days post-stroke were invited to participate in a telephone survey related to their 6 or 12 month post-stroke activities of daily living (ADLs) during March-May 2013. ADL score (average of 7 items, range 1-4) was analyzed by self-reported ethnicity using repeated measures models. In a separate sample interviewed at 90 days, patients were asked about willingness to participate in longer term follow-up and a subset of caregivers responded to the caregiver strain index (CSI, range 1-13, higher is worse). Results: Among patients alive at the time of interview, 87% of 39 MA and 74% of 19 NHW participated in the 6 month interview, and 84% of 32 MA and 88% of 8 NHW participated in the 12 month interview. No patients refused at either time point; the remainder could not be contacted. The figure shows trajectories of ADL score by ethnicity, and worsening scores among MA over time. Interest in longer-term follow-up was high (96% of 25 NHWs and 97% of 38 MAs). Caregivers of MA stroke survivors were most often children (41%) followed by spouses (36%), but were spouses (43%) followed by children (29%) for NHWs. Of 29 caregivers interviewed, 54% of MA and 57% of NHW reported being strained (CSI≥7). Caregiver strain was associated with 90-day ADL score: prevalence ratio = 1.34, 95%CI (1.01, 1.76) for 1 unit increase in ADL score. Conclusions: Our data demonstrate the feasibility of recruiting MA stroke survivors for long-term outcome assessments and suggests that MAs have worse functional outcome and greater functional declines than NHWs. The informal caregiver burden is related to functional outcome and is high in both ethnic groups.

Abstract TP127: Mortality and Recurrence in Atherosclerotic Ischemic Stroke: Long-term Follow-up

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Miguel A Barboza ◽  
Rodrigo Uribe ◽  
Fabiola Serrano ◽  
Luis C Becerra-Pedraza ◽  
D. K Mantilla-Barbosa ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Functional Outcome ◽  
Median Time ◽  
Smoking History ◽  
Stroke Recurrence ◽  
Active Smoking ◽  
Long Term Outcome ◽  
Long Term Follow Up

Background and purpose: Atherosclerotic ischemic stroke is the second most frequent etiology of stroke in the adult population. Functional outcome, mortality and recurrence of stroke rates on the long-term follow-up are poorly studied. This study investigates long-term outcome among patients with ischemic stroke secondary to atherosclerotic causality, and identifies the main factors associated with poor outcome, recurrence, and death. Methods: We analyzed data from our consecutive acute ischemic stroke database, over a period of 25 years (1990-2015). The endpoints were: bad outcome (Modified Rankin Score ≥3), recurrence and mortality at discharge, and final follow-up. Multivariate Cox and Kaplan-Meier analysis were used to estimate the probability of death and recurrence. Results: A total of 946 consecutive atherosclerotic stroke patients were included (571 [60.4%] males, median age 65 years [interquartile range 57-73 years] for the entire population); dyslipidemia (64.2%), hypertension (63.3%), diabetes (35.0%), and active smoking history (31.8%) were the most prevalent risk factors.After a median follow-up of 38 months (IQR 12-75 months), 59.3% patients had a bad outcome at discharge. A result of 26.1% had stroke recurrence (median time until recurrence: 9 months [IQR 12-84 months], with 12.9% cases presenting ≥2 recurrences), and 24.1% were dead (median time to death: 18.5 months [IQR 11-74 months]) at the final follow-up period. After multivariate adjustment, hypertension (HR 4.2, CI 95% 2.8-6.1; p<0.001) was the strongest predictor of recurrence. Additionally, diabetes (HR 2.6, CI 95% 2.0-3.5; p<0.001), bad functional outcome after recurrence (HR 2.3, CI 95% 1.9-2.9; p<0.001), age ≥65 years (HR 2.2, CI 95% 1.7-2.9; p<0.001), and active smoking (HR 1.8, CI 95% 1.3-2.3; p<0.001) were the strongest predictors of mortality. Conclusions: Atherosclerotic ischemic stroke has a high rate of recurrence, associated mainly with hypertension. Mortality is predicted by diabetes, bad functional outcome at recurrence, and older age.

scholarly journals Return to work after stroke – Feasibility of 6-year follow-up

2018 ◽  
Vol 82 (1) ◽  
pp. 27-37 ◽  
Author(s):  
Julie Phillips ◽  
Kathryn Gaffney ◽  
Margaret Phillips ◽  
Kate Radford
Keyword(s):  
Quality Of Life ◽  
Functional Ability ◽  
Feasibility Trial ◽  
Stroke Survivors ◽  
Full Time ◽  
Voluntary Work ◽  
Post Stroke

Introduction Little is known about long-term work sustainability of stroke survivors. A feasibility trial of early stroke specialist vocational rehabilitation had 32/46 (69.5%) participants available for follow-up at 12 months post stroke. Of these, 19/32 (59.4%) were in work. This study aims to determine the feasibility of longer-term follow-up and explore work status 6 years post stroke. Method Forty-eight participants fitting criteria for the feasibility trial were sent postal questionnaires measuring employment, income, mood, functional ability and quality of life, and were invited for interview to explore working 6 years after stroke. Ethical approval was obtained. Results Of the 48 participants, five (10.4%) had died; 19/43 (44.2%) responded. Fourteen were men; mean age 62 (24–78) years. Fourteen (74%) reported working (paid work n = 10, voluntary work n = 3, full-time education n = 1). Five had retired. Most (11/13) remained with preinjury employers. Half (8/15, 53%) reported decreased income since stroke. Compared to one year, median functional ability was marginally higher (extended activities of daily living 63 (IQR 8, range 32–66) to 60 (IQR 9, range 17–66)), but health-related quality of life was lower (EuroQuol Visual Analogue Scale mean 77.4 [SD 11] to 70.7 [SD14]). Six interviewees felt returning to work was the correct decision but struggled with invisible impairments. Conclusion This study suggests that long-term follow-up is feasible and that those who made a good recovery were more likely to respond. Work remains important to stroke survivors 6 years post stroke.

scholarly journals Management and Outcome of Hindfoot Trauma With Concomitant Talar Head Injury

2021 ◽  
pp. 107110072098002
Author(s):  
Esmee Wilhelmina Maria Engelmann ◽  
Olivier Wijers ◽  
Jelle Posthuma ◽  
Tim Schepers
Keyword(s):  
Functional Outcome ◽  
Case Series ◽  
Ankle Injuries ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Long Term Outcome ◽  
Talar Head ◽  
The Mean

Background: Talar head fractures account for 2.6% to 10% of all talar fractures and are often associated with concomitant musculoskeletal injuries. The current literature only describes a total of 14 patients with talar head fractures and, with that, guidelines for management are lacking. The aim of the current study was to evaluate the management and long-term outcome of patients who have hindfoot trauma with concomitant talar head fractures. Methods: This study includes a retrospective cohort of patients with talar head fractures. Patient characteristics, trauma mechanism, fracture characteristics, treatment, follow-up, and complications were reported. Functional outcome was assessed using the Foot Function Index (FFI) and the American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot score. Quality of life was measured by the EuroQol-5D (EQ-5D). Twenty-one patients with acute fractures of the talar head were identified. The mean follow-up time was 4.9 years. Results: All patients sustained additional ipsilateral foot and/or ankle injuries. Fifteen patients had operative management of their talar head fracture. There were no postoperative wound infections and no cases of avascular necrosis. All fractures united, and 29% of patients developed posttraumatic osteoarthritis. The overall mean FFI score index was 34.2, and the mean AOFAS score was 70.7. The mean EQ-5D index score was 0.74. Conclusion: Talar head fractures always coincided with other (foot) fractures. Management and long-term functional outcome were affected by the extent of associated injuries. Due to the low incidence and high complexity of talar head fractures, early referral to dedicated foot surgeons and centralization of complex foot surgery is recommended. Level of Evidence: Level IV, retrospective case series.

scholarly journals Skull base surgery for tumors in children: long-term clinical and functional outcome

2013 ◽  
Vol 11 (5) ◽  
pp. 496-503 ◽  
Author(s):  
Caroline Hayhurst ◽  
Dawn Williams ◽  
Jawad Yousaf ◽  
David Richardson ◽  
Barry Pizer ◽  
...  
Keyword(s):  
Adjuvant Therapy ◽  
Hospital Stay ◽  
Functional Outcome ◽  
Skull Base ◽  
Skull Base Surgery ◽  
Surgical Morbidity ◽  
Long Term Outcome ◽  
Csf Leakage

Object Skull base tumors in children are rare but require complex approaches with potential morbidity to the developing craniofacial skeleton, in addition to tumor-related morbidity. Reports of long-term clinical and functional outcome following skull base approaches in children are scarce. The authors report long-term outcome in children with tumors undergoing multidisciplinary skull base surgery. Methods A retrospective analysis was undertaken of children undergoing surgery at a single institution between 1998 and 2008 for benign and malignant lesions of the anterior, middle, or posterior cranial base. Patients with craniopharyngioma, pituitary tumors, and optic glioma were excluded. Histology, surgical morbidity, length of hospital stay, progression-free survival, and adjuvant therapy were recorded. Functional and cognitive outcome was assessed prospectively using the Late Effects Severity Score (LESS). Results Twenty-three children ranging in age from 13 months to 15 years underwent skull base approaches for resection of tumors during the study period. The median follow-up duration was 60 months. Tumor types included meningioma, schwannoma, rhabdomyosarcoma, neuroblastoma, angiofibroma, and chordoma. Complete resection was achieved in 12 patients (52%). Thirteen patients (57%) had benign histology. The median hospital stay was 7 days. There were 3 deaths, 1 perioperative and 2 from tumor progression. Two patients had CSF leakage (9%) and 2 developed meningitis. Two children (9%) had residual neurological deficit at last follow-up evaluation. Thirteen (59%) of 22 surviving patients received adjuvant therapy. The majority of the patients remain in mainstream education and 19 of the 20 surviving children have an LESS of 3 or lower. Conclusions Children tolerate complex skull base procedures well, with minimal surgical-related morbidity as well as good long-term tumor control rates and functional outcomes from maximal safe resection combined with adjuvant treatment when required.

Long-term outcome predictors after functional remediation in patients with bipolar disorder

2020 ◽  
pp. 1-9 ◽  
Author(s):  
B. Solé ◽  
C. M. Bonnín ◽  
J. Radua ◽  
L. Montejo ◽  
B. Hogg ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Functional Outcome ◽  
Verbal Memory ◽  
Psychosocial Interventions ◽  
Clinical Variable ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Partial Correlations

Abstract Background Improving functioning in patients with bipolar disorder (BD) is one of the main objectives in clinical practice. Of the few psychosocial interventions that have been specifically developed to enhance the psychosocial outcome in BD, functional remediation (FR) is one which has demonstrated efficacy. The aim of this study was to examine which variables could predict improved functional outcome following the FR intervention in a sample of euthymic or subsyndromal patients with BD. Methods A total of 92 euthymic outpatients were included in this longitudinal study, with 62 completers. Partial correlations controlling for the functional outcome at baseline were calculated between demographic, clinical and neurocognitive variables, and functional outcome at endpoint was assessed by means of the Functioning Assessment Short Test scale. Next, a multiple regression analysis was run in order to identify potential predictors of functional outcome at 2-year follow-up, using the variables found to be statistically significant in the correlation analysis and other variables related to functioning as identified in the previous scientific literature. Results The regression model revealed that only two independent variables significantly contributed to the model (F(6,53): 4.003; p = 0.002), namely verbal memory and inhibitory control. The model accounted for 31.2% of the variance. No other demographic or clinical variable contributed to the model. Conclusions Results suggest that patients with better cognitive performance at baseline, especially in terms of verbal memory and executive functions, may present better functional outcomes at long term follow-up after receiving functional remediation.

scholarly journals Functional outcome of patients with unstable pelvic ring fracture

2017 ◽  
Vol 25 (1) ◽  
pp. 230949901668432 ◽  
Author(s):  
Yasuo Kokubo ◽  
Hisashi Oki ◽  
Daisuke Sugita ◽  
Kenichi Takeno ◽  
Tsuyoshi Miyazaki ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Lower Extremity ◽  
Functional Outcome ◽  
Pelvic Ring ◽  
Nerve Damage ◽  
Short Term ◽  
Term Outcome ◽  
Long Term Outcome

The purpose of this study was to evaluate factors that correlated with unsatisfactory short- and long-term outcome in patients who sustained unstable pelvic ring fracture. The study subjects of this study were those of type B and C pelvic ring fractures (82 patients; mean age 54 years). Age, gender, associated injuries, fracture type, Injury Severity Score rating and treatment methods were assessed, and Majeed score for functional outcome and radiographic studies at 1 year after injury (short-term) and at final follow-up (long-term), with mean follow-up of 98 months were analyzed. Significant univariate factors ( p < 0.05) were entered in a multivariate logistic regression model to determine the independent predictors of unsatisfactory functional outcome. Univariate analysis showed that fractures of the lower extremity, nerve damage, conservative treatment, and radiological outcome correlated with unsatisfactory short-term functional outcome, while female gender, brain injury, nerve damage, conservative treatment, fracture location at the posterior portion of pelvic ring, radiological outcome, and pure sacroiliac dislocation only for type C fracture correlated with unsatisfactory long-term outcome. Multiple logistic regression analysis identified fractures of the lower extremity (odds ratio (OR): 5.364), conservative treatment (OR: 13.690), and nerve damage (OR: 21.392) as determinants of unsatisfactory short-term functional outcome and nerve damage (OR: 66.926) and poor radiological results (OR: 33.944) as determinant of long-term functional outcome. In patients with unstable pelvic ring injury, fractures of the lower extremity, conservative therapy, and nerve damage influenced short-term functional outcome, while that nerve damage and the pelvic ring displacement over 20 mm negatively affected long-term outcome.

scholarly journals Long term Post-Stroke Functional Outcomes: a comparison of diabetics and non-diabetics

2021 ◽  
Author(s):  
Deidre Anne de Silva ◽  
Kaavya Narasimhalu ◽  
Ian Wang Huang ◽  
Fung Peng Woon ◽  
John C. Allen ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Functional Outcome ◽  
Functional Outcomes ◽  
Age Group ◽  
Stroke Patients ◽  
Poor Functional Outcome ◽  
Post Stroke ◽  
The Impact

Introduction: Diabetes mellitus (DM) is known to influence outcomes in the short-term following stroke. However, the impact of DM on long-term functional outcomes after stroke is unclear. We compared functional outcomes periodically over 7 years between diabetic and non-diabetic ischemic stroke patients and investigated the impact of DM on the long-term trajectory of post-stroke functional outcomes. We also studied the influence of age on the diabetes-functional outcome association. Methods: This is a longitudinal observational cohort study of 802 acute ischemic stroke patients admitted to the Singapore General Hospital from 2005 to 2007. Functional outcomes were assessed using the modified Rankin Scale (mRS) with poor functional outcome defined as mRS≥3. Follow-up data was determined at 6 months and at median follow-up durations of 29 and 86 months. Results: Among the 802 ischemic stroke patients studied (mean age 64 ± 12 years, male 63%), 42% had DM. In regression analyses adjusting for covariates, diabetic patients were more likely to have poor functional outcomes at 6 months (OR=2.12, 95% CI: 1.23–3.67) and at median follow-up durations of 29 months (OR=1.96, 95% CI: 1.37–2.81) and 86 months (OR=2.27, 95% CI: 1.58–3.25). In addition, age modulated the effect of DM, with younger stroke patients (≤65 years) more likely to have long term poor functional outcome at the 29-month (p=0.0179) and 86-month (p=0.0144) time points. Conclusions: DM was associated with poor functional outcomes following ischemic stroke in the long term with the effect remaining consistent throughout the 7-year follow-up period. Age modified the effect of DM in the long term, with an observed increase in risk in the ≤65 age group but not in the >65 age group.

Abstract 57: The Effect Of Routine Oxygen Supplementation on Long Term Functional Outcomes and Quality of Life After Stroke: 6 and 12 Month Outcomes The Stroke Oxygen Study

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
◽  
Tracy Nevatte ◽  
Julius Sim ◽  
Richard Gray ◽  
Natalie Ives ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Acute Stroke ◽  
Repeated Measures ◽  
Oxygen Supplementation ◽  
Long Term Outcome ◽  
Definitive Answer ◽  
Early Results

Introduction: Routine oxygen supplementation (ROS) is commonly prescribed to prevent stroke-related hypoxia and secondary brain damage. However, early results of The Stroke Oxygen Study (SO2S) show that routine oxygen supplementation does not affect mortality and disability at 3 months. Objectives: to establish whether routine oxygen supplementation early after acute stroke improves long-term functional outcome and quality of life after stroke. Methods: SO2S is a large multicentre randomized controlled trial. Patients with acute stroke were eligible for inclusion within 24h of hospital admission if they had no definite indications for or contraindications to oxygen treatment. Participants were randomised 1:1:1 to continuous oxygen, oxygen at night (between 21:00-06:00) only, or to control (room air) for 72 h. Oxygen was given at a rate of 3L/min if the baseline oxygen saturation was ≤93% and at 2L/min if it was >93%. Follow-up was at 3, 6 and 12 months by postal questionnaire with telephone follow-up for non-responders. Results: 8003 participants were recruited from 136 hospitals in the UK from April 2008 to June 2013. The median age was 74 (range 19-100) y, 4398 (54.9%) were male, and the baseline NIHSS score was 5 (range 0-34). We will present long-term outcomes including mortality, disability (mRS), the ability to perform activities of daily living (BI, NEADL) and quality of life (EQ5D). Comparisons will be between ROS and control, and between nocturnal versus continuous ROS. A longitudinal repeated measures analysis across all three time points (3, 6 and 12 months) will also be presented. Conclusion: The results of this large study will give a definitive answer to the question whether routine oxygen supplementation affects long-term outcome. They will also show whether there is a difference in the level of effectiveness when oxygen is given continuously rather than at night only, when patients are most likely to become hypoxic.

Klinische Langzeitergebnisse der perkutanen transluminalen Angioplastie bei Patienten mit peripherer arterieller Verschlusskrankheit

VASA ◽  
2002 ◽  
Vol 31 (1) ◽  
pp. 36-42 ◽  
Author(s):  
. Bucek ◽  
Hudak ◽  
Schnürer ◽  
Ahmadi ◽  
Wolfram ◽  
...  
Keyword(s):  
Success Rate ◽  
Clinical Stage ◽  
Ankle Brachial Index ◽  
Clinical Situation ◽  
Clinical Results ◽  
Transluminal Angioplasty ◽  
Term Outcome ◽  
Long Term Outcome

Background: We investigated the long-term clinical results of percutaneous transluminal angioplasty (PTA) in patients with peripheral arterial occlusive disease (PAOD) and the influence of different parameters on the primary success rate, the rate of complications and the long-term outcome. Patients and methods: We reviewed clinical and hemodynamic follow-up data of 166 consecutive patients treated with PTA in 1987 in our department. Results: PTA improved the clinical situation in 79.4% of patients with iliac lesions and in 88.3% of patients with femoro-popliteal lesions. The clinical stage and ankle brachial index (ABI) post-interventional could be improved significantly (each P < 0,001), the same results were observed at the end of follow-up (each P < 0,001). Major complications occurred in 11 patients (6.6%). The rate of primary clinical long-term success for suprainguinal lesions was 55% and 38% after 5 and 10 years (femoro-popliteal 44% and 33%), respectively, the corresponding data for secondary clinical long-term success were 63% and 56% (60% and 55%). Older age (P = 0,017) and lower ABI pre-interventional (P = 0,019) significantly deteriorated primary clinical long-term success for suprainguinal lesions, while no factor could be identified influencing the outcome of femoro-popliteal lesions significantly. Conclusion: Besides an acceptable success rate with a low rate of severe complications, our results demonstrate favourable long-term clinical results of PTA in patients with PAOD.

Psychopathology 8½ Years Post Parasuicide

Crisis ◽  
1999 ◽  
Vol 20 (3) ◽  
pp. 115-120 ◽  
Author(s):  
Stephen Curran ◽  
Michael Fitzgerald ◽  
Vincent T Greene
Keyword(s):  
Rating Scales ◽  
Psychiatric Morbidity ◽  
Parental Bonding ◽  
Social Maladjustment ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Face To Face ◽  
Long Term Follow Up

There are few long-term follow-up studies of parasuicides incorporating face-to-face interviews. To date no study has evaluated the prevalence of psychiatric morbidity at long-term follow-up of parasuicides using diagnostic rating scales, nor has any study examined parental bonding issues in this population. We attempted a prospective follow-up of 85 parasuicide cases an average of 8½ years later. Psychiatric morbidity, social functioning, and recollections of the parenting style of their parents were assessed using the Clinical Interview Schedule, the Social Maladjustment Scale, and the Parental Bonding Instrument, respectively. Thirty-nine persons in total were interviewed, 19 of whom were well and 20 of whom had psychiatric morbidity. Five had died during the follow-up period, 3 by suicide. Migration, refusals, and untraceability were common. Parasuicide was associated with parental overprotection during childhood. Long-term outcome is poor, especially among those who engaged in repeated parasuicides.

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