The George Institute for Global Health, 2050 Australia.
Stroke. 2011 Feb;42(2):433-8. doi: 10.1161/STROKEAHA.110.596627. Epub 2010 Dec 23.
Limited information exists on the long-term consequences of stroke in China. We aimed to describe the profile and determinants of health-related quality of life among 12-month survivors of stroke.
The ChinaQUEST (QUality Evaluation of Stroke care and Treatment) study was a prospective 62-hospital registry study of patients with acute stroke (ischemic stroke and intracerebral hemorrhage). Health-related quality of life was determined in 12-month survivors using a 35-item quality-of-life questionnaire (QOL-35) designed specifically for use in Chinese people. Proxy responses were used in those who were unable to personally complete the QOL-35.
A total of 4283 12-month stroke survivors completed assessments directly (1730 [40.4%]) or by a proxy (2553 [59.6%]). Mean (SD) health-related quality of life scores were higher in self-responders (70 [0.3] out of a best possible 100 score) than in proxy responders (60 [0.3]; P<0.001). The strongest baseline variables that predicted "low" (below median) health-related quality of life scores in self-responders were having a lower income (income <10 000 Chinese Yuan Renminbi [CNY, approximately US $1428] versus >19 000 CNY [approximately US $2714]; OR, 2.06; 95% CI, 1.37 to 3.10) and being disabled at discharge (OR, 3.65; 95% CI, 2.72 to 4.91). Proxy responders had similar predictive factors, including being disabled at discharge (OR, 4.99; 95% CI, 4.00 to 6.21), but income was not significant.
In China, the strongest predictor of 12-month health-related quality of life after stroke is level of disability at hospital discharge. Level of income was another important factor. Health insurance schemes that offset the economic impact of stroke could help improve the health and well-being of Chinese people affected by stroke.
关于中国脑卒中患者的长期预后，相关信息有限。本研究旨在描述脑卒中 12 个月幸存者的健康相关生活质量的特点和决定因素。
中国 QUEST（脑卒中护理和治疗质量评估）研究是一项前瞻性的 62 家医院的注册研究，纳入了急性脑卒中（缺血性卒中和脑出血）患者。采用专门为中国人设计的 35 项生活质量问卷（QOL-35）评估 12 个月幸存者的健康相关生活质量。在那些无法亲自完成 QOL-35 的患者中，使用代理人进行应答。
共有 4283 名 12 个月脑卒中幸存者直接（1730 名[40.4%]）或通过代理人（2553 名[59.6%]）完成了评估。亲自应答者的健康相关生活质量评分均值（SD）更高（100 分满分，得分为 70 [0.3]分），而代理人应答者的评分更低（60 [0.3]分；P<0.001）。亲自应答者中，预测健康相关生活质量“低”（低于中位数）评分的最强基线变量是收入较低（收入<10 000 元人民币[CNY]，约 1428 美元[19 000 CNY]，约 2714 美元）和出院时残疾（OR，2.06；95%CI，1.37 至 3.10）。代理人应答者也有类似的预测因素，包括出院时残疾（OR，4.99；95%CI，4.00 至 6.21），但收入无统计学意义。
在中国，脑卒中后 12 个月健康相关生活质量的最强预测因素是出院时的残疾程度。收入也是另一个重要因素。补偿脑卒中经济影响的健康保险计划可以帮助改善中国脑卒中患者的健康和福祉。
