Suenkeler Inga H, Nowak Margarete, Misselwitz Björn, Kugler Christof, Schreiber Wolfgang, Oertel Wolfgang H, Back Tobias
Neurological Hospital, Hubertus Str 3-7, 35619 Braunfels, Germany.
J Neurol. 2002 Sep;249(9):1160-7. doi: 10.1007/s00415-002-0792-3.
To study the timecourse of health-related global and domain-specific quality of life (QOL) in patients presenting with stroke or transient ischemic attacks (TIA) up to one year after the ischemic event. Variables were identified that may predict poststroke life satisfaction.
In this prospective study, a cohort of 183 stroke/TIA patients was followed up at 3, 6, and 12 months. A total of 144 survivors completed the follow-up (65 women, 79 men, mean age 65.3 years). Health-related QOL was assessed by the Short Form 36 (SF-36) questionnaire, the neurological status by the European Stroke Scale (ESS). Disability was evaluated by using the Barthel index and the modified Swedish Stroke Registry Follow-up Form; depression was scored by the Montgomery-Asberg Depression Rating Scale (MADRS).
One year after stroke/TIA, 66 % of patients reported a worsening of life satisfaction compared with the prestroke level. The SF-36 physical component summary was reduced throughout the observation period. The SF-36 mental component summary deteriorated between the 6- and 12-months follow-up from 52.2 +/- 7.1 to 50.6 +/- 7.1 (p < 0.05). The SF-36 domains "physical functioning", "social functioning" and the MADRS scores both showed a significant deterioration between 6 and 12 months poststroke (p < 0.05). In contrast, the neurological status and the degree of disability remained stable. Male sex, absence of diabetes, and normal MADRS scores at 3 and 6 months postinsult were identified as predictors of favorable QOL after 1 year (p < 0.05).
Despite stable neurologic function and disability, global as well as domain-specific measures of QOL deteriorated over the 12-months observation period in a cohort of stroke survivors.
研究缺血性事件发生后长达一年的中风或短暂性脑缺血发作(TIA)患者与健康相关的总体及特定领域生活质量(QOL)的时间进程。确定可能预测中风后生活满意度的变量。
在这项前瞻性研究中,对183名中风/TIA患者队列进行了3个月、6个月和12个月的随访。共有144名幸存者完成了随访(65名女性,79名男性,平均年龄65.3岁)。通过简短健康调查问卷36项(SF-36)评估与健康相关的生活质量,通过欧洲卒中量表(ESS)评估神经状态。使用巴氏指数和改良的瑞典卒中登记随访表评估残疾情况;用蒙哥马利-艾斯伯格抑郁评定量表(MADRS)对抑郁进行评分。
中风/TIA发生一年后,66%的患者报告生活满意度较中风前水平有所下降。在整个观察期内,SF-36身体成分总结得分降低。SF-36心理成分总结得分在6个月至12个月随访期间从52.2±7.1降至50.6±7.1(p<0.05)。SF-36领域“身体功能”“社会功能”以及MADRS评分在中风后6至12个月均显示出显著恶化(p<0.05)。相比之下,神经状态和残疾程度保持稳定。男性、无糖尿病以及发病后3个月和6个月时MADRS评分正常被确定为1年后生活质量良好的预测因素(p<0.05)。
在一组中风幸存者中,尽管神经功能和残疾状况稳定,但在12个月的观察期内,总体及特定领域的生活质量指标均有所恶化。