Upright activity within the first week after stroke is associated with better functional outcome and health-related quality of life: A Norwegian multi-site study

Background: The concept of enhanced recovery after total hip arthroplasty is gaining worldwide interest, as it shortens the length of hospital stay without an increase of complications. The aim of the study was to investigate the functional outcome and health-related quality of life 12 months after cementless total hip arthroplasty with the use of an enhanced recovery concept in comparison to a conventional rehabilitation. Material and Methods: 320 patients were retrospectively analyzed who underwent primary cementless total hip arthroplasty (THA). A total of 123 of the patients received an enhanced recovery program (ERAS) and 197 patients a conventional rehabilitation (Non-ERAS). Twelve months postoperatively, a clinical examination was performed regarding satisfaction, function and pain. Results were evaluated using WOMAC, EQ-5D-5L and EQ-VAS. A 1:1 matching was performed to correct for confounding variables, regarding age, sex and ASA score. Finally, 122 patients (n = 61, in each group) were analyzed and compared. Results: Patients showed a significant improvement of WOMAC total score, subscale pain, subscale stiffness and subscale function from preoperative to the follow up after 12 months in both groups, with significantly superior results for the WOMAC total score for the ERAS group (p = 0.042). EQ-5D and EQ-5D VAS showed a significant improvement from preoperative to 12 months postoperative (p < 0.001) for both groups, while no difference regarding the group-comparison was shown. Conclusion: Health-related quality of life and functional outcome increased to excellent values after total hip arthroplasty with the use of an enhanced recovery concept and a conventional rehabilitation, with a superior WOMAC total score for ERAS and a tendency to better results for health-related quality of life for patients with ERAS within the follow up after 12 months.

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Long-term health-related quality of life, survival and costs by different levels of functional outcome six months after stroke

European Stroke Journal ◽

10.1177/2396987317753444 ◽

2018 ◽

Vol 3 (2) ◽

pp. 157-164 ◽

Cited By ~ 3

Author(s):

Ann-Sofie Rudberg ◽

Eivind Berge ◽

Anders Gustavsson ◽

Per Näsman ◽

Erik Lundström

Keyword(s):

Quality Of Life ◽

Functional Outcome ◽

Economic Evaluations ◽

Health Related Quality ◽

Term Survival ◽

Related Quality ◽

Health Related ◽

The Impact

Introduction Information about the impact of functional outcome after stroke is currently missing on health-related quality of life, survival and costs. This information would be valuable for health economic evaluations and for allocation of resources in stroke health care. Patients and methods Data on 297 Swedish patients included in the Third International Stroke Trial were analysed including functional outcome at six months (measured by Oxford Handicap Scale), health-related quality of life up to 18 months (EQ-5D-3L) and survival up to 36 months. We used record linkage to collect data on costs up to 36 months, using national patient registers. Results Patients with a better functional outcome level at six months had a significantly better health-related quality of life at 18 months ( p < 0.05), better long-term survival ( p < 0.05) and lower costs ( p < 0.001), for all time points up to 36 months. The difference in costs was mainly due to differences in days spent in hospital ( p < 0.005). Discussion This study showed an association between functional outcome at six months and health-related quality of life up to 18 months, and costs up to 36 months. Conclusion Functional outcome six months after stroke is an important determinant of health-related quality of life, survival and costs over 36 months. Effective interventions aimed at reducing short-term disability levels are therefore also expected to reduce the overall burden of stroke.

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Functional outcome and health-related quality of life 10 years after moderate-to-severe traumatic brain injury

Acta Neurologica Scandinavica ◽

10.1111/j.1600-0404.2008.01116.x ◽

2009 ◽

Vol 120 (1) ◽

pp. 16-23 ◽

Cited By ~ 118

Author(s):

N. Andelic ◽

N. Hammergren ◽

E. Bautz-Holter ◽

U. Sveen ◽

C. Brunborg ◽

...

Keyword(s):

Quality Of Life ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Functional Outcome ◽

Severe Traumatic Brain Injury ◽

Health Related Quality ◽

Related Quality ◽

Health Related

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Patient-reported, health-related, quality of life after stroke thrombectomy in clinical practice

Neurology ◽

10.1212/wnl.0000000000010356 ◽

2020 ◽

Vol 95 (12) ◽

pp. e1724-e1732 ◽

Cited By ~ 2

Author(s):

Milani Deb-Chatterji ◽

Alexander Konnopka ◽

Fabian Flottmann ◽

Hannes Leischner ◽

Jens Fiehler ◽

...

Keyword(s):

Quality Of Life ◽

Clinical Practice ◽

Functional Outcome ◽

Health Related Quality ◽

Patient Reported ◽

Health Domains ◽

Related Quality ◽

Health Related ◽

Reported Health

ObjectiveTo determine patient-reported health-related quality of life (HRQOL) after stroke thrombectomy in clinical practice and to identify predictors of better HRQOL by analyzing data of 504 consecutive patients treated in a large university stroke center.MethodsAll patients with stroke treated by thrombectomy (June 2015–October 2018) were prospectively enrolled in this observational study. At 90 days, functional outcome was assessed by the modified Rankin Scale (mRS) and patient-reported HRQOL was assessed by the EuroQol Group 5-Dimension (EQ-5D) self-report questionnaire, consisting of 5 health domains. The EQ-5D utility index (EQ-5D-I) score (−0.594 to 1.00, with higher values indicating better HRQOL) was calculated. Linear regression analysis was applied to identify predictors of better HRQOL (higher EQ-5D-I score).ResultsOf 504 patients (median age 76 years, 51.8% female), the mean EQ-5D-I score was 0.39 (SD 0.44). The proportion of stroke survivors who reported complaints in the different domains decreased from 66% in Usual Activities to 57% in Mobility, 50.4% in Self-Care, 41.7% in Pain/Discomfort, and 40.8% Anxiety/Depression. Lower age, lower prestroke mRS score, lower baseline NIH Stroke Scale score, higher Alberta Stroke Program Early CT Score, concomitant thrombolysis therapy, and a successful recanalization were independent predictors of better HRQOL.ConclusionsPatient-reported HRQOL provides a more comprehensive assessment of stroke outcome than the mRS score. Health domains involving motor function most frequently showed complaints in HRQOL after stroke thrombectomy, while a large proportion of patients did not report any complaints across the different health domains. Predictors of better HRQOL closely match the predictors of better functional outcome measured by the mRS in other thrombectomy studies.

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