Haacke Caroline, Althaus Astrid, Spottke Annika, Siebert Uwe, Back Tobias, Dodel Richard
Department of Neurology, Philipps-University Marburg, Germany.
Stroke. 2006 Jan;37(1):193-8. doi: 10.1161/01.STR.0000196990.69412.fb. Epub 2005 Dec 8.
As stroke mortality rates decline, individuals are increasingly likely to live with their residual impairments and disabilities. Therefore, the quality of poststroke life is 1 of the pivotal topics that have to be considered beneath the functional outcome. However, data on health-related quality of life (HRQoL) have been infrequently used in stroke trials. The purpose of this study was to examine the long-term outcome (4 years after stroke) of HRQoL and to identify the determinants of HRQoL in stroke survivors.
Seventy-seven patients were included who were admitted to the Department of Neurology, Philipps-University Marburg, after experiencing an ischemic stroke, a transient ischemic attack, or a hemorrhagic stroke. All patients were examined by a physician, and assessment was performed using a standardized questionnaire. HRQoL was assessed using the German version of the EuroQoL Index (EQ-5D) and the Health Utility Index 2 and 3 (HUI2/3).
Four years after stroke, besides physical functioning, neuropsychological sequelae such as depression and cognitive impairment contributed to a reduced HRQoL. In addition, the incidence of incontinence proved to be an important factor for HRQoL. Explained variances in regression analysis models were high (R2=0.802 for HUI and 0.633 for EQ-5D--visual analogue scale) and were based on a few important determinants, including physical state, depression, cognitive impairment, and incontinence.
Our results underscore the importance of nonmotor symptoms on HRQoL in patients with stroke.
随着卒中死亡率的下降，患者越来越有可能带着残余的损伤和残疾生活。因此，卒中后生活质量是在功能结局之外必须考虑的关键话题之一。然而，与健康相关的生活质量（HRQoL）数据在卒中试验中很少被使用。本研究的目的是探讨HRQoL的长期结局（卒中后4年），并确定卒中幸存者HRQoL的决定因素。
纳入了77例因缺血性卒中、短暂性脑缺血发作或出血性卒中入住马尔堡菲利普斯大学神经病学系的患者。所有患者均由医生进行检查，并使用标准化问卷进行评估。使用德语版的欧洲生活质量指数（EQ-5D）以及健康效用指数2和3（HUI2/3）对HRQoL进行评估。
卒中后4年，除身体功能外，抑郁和认知障碍等神经心理后遗症导致HRQoL下降。此外，尿失禁的发生率被证明是影响HRQoL的一个重要因素。回归分析模型中的解释方差很高（HUI的R2=0.802，EQ-5D视觉模拟量表的R2=0.633），且基于一些重要的决定因素，包括身体状态、抑郁、认知障碍和尿失禁。
我们的结果强调了非运动症状对卒中患者HRQoL的重要性。
