Andrew N E, Kilkenny M F, Lannin N A, Cadilhac D A
Translational Public Health Division, Stroke and Ageing Research, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia.
Florey Institute of Neuroscience and Mental Health, Heidelberg, VIC, Australia.
Qual Life Res. 2016 Aug;25(8):2053-62. doi: 10.1007/s11136-016-1234-5. Epub 2016 Feb 4.
Understanding the relationship between health-related quality of life (HRQoL) and long-term unmet needs is important for guiding services to optimise life following stroke. We investigated whether HRQoL between 90 and 180 days following stroke was associated with long-term unmet needs.
Data from Australian Stroke Clinical Registry (AuSCR) registrants who participated in the Australian Stroke Survivor Needs Survey were used. Outcome data, including the EQ-5D, are routinely collected in AuSCR between 90 and 180 days post-stroke. Unmet needs were assessed at a median of 2 years and categorised into: health; everyday living; work/leisure; and support domains. Multivariable regression was used to determine associations between the EQ-5D dimensions and the likelihood of experiencing unmet needs and the visual analogue scale (VAS) (rating 0-100) and number of reported unmet needs.
In total, 173 AuSCR registrants completed the Needs Survey (median age 69 years, 67 % male; 77 % ischaemic stroke). VAS scores were negatively associated with the number of reported long-term unmet needs [irr 0.98, (95 % CI 0.97, 0 99) p < 0.001]. Having EQ-5D activity limitations was associated with unmet living needs (aOR 4.5, 95 % CI 1.1, 18.8). Requiring living supports at 90-180 days was associated with unmet health needs (aOR 4.9, 95 % CI 1.5, 16.1). Those with pain at 90-180 days were less likely to report unmet health (aOR 0.09, 95 % CI 0.02, 0.4) and support needs (aOR 0.2, 95 % CI 0.06, 0.6).
Routinely collected HRQoL data can identify survivors at risk of experiencing long-term unmet needs. This information is important for targeting service delivery to optimise outcomes following stroke.
了解健康相关生活质量（HRQoL）与长期未满足需求之间的关系，对于指导服务以优化中风后的生活非常重要。我们调查了中风后90至180天的HRQoL是否与长期未满足需求相关。
使用来自参与澳大利亚中风幸存者需求调查的澳大利亚中风临床注册中心（AuSCR）登记者的数据。包括EQ-5D在内的结局数据在AuSCR中于中风后90至180天定期收集。未满足需求在中位数2年时进行评估，并分为：健康；日常生活；工作/休闲；以及支持领域。多变量回归用于确定EQ-5D维度与经历未满足需求的可能性以及视觉模拟量表（VAS）（评分0 - 100）和报告的未满足需求数量之间的关联。
共有173名AuSCR登记者完成了需求调查（中位年龄69岁，67%为男性；77%为缺血性中风）。VAS评分与报告的长期未满足需求数量呈负相关[风险比0.98，（95%置信区间0.97，0.99）p < 0.001]。EQ-5D存在活动受限与未满足的生活需求相关（调整后比值比4.5，95%置信区间1.1，18.8）。在90至180天需要生活支持与未满足的健康需求相关（调整后比值比4.9，95%置信区间1.5，16.1）。在90至180天有疼痛的人报告未满足健康需求（调整后比值比0.09，95%置信区间0.02，0.4）和支持需求（调整后比值比0.2，95%置信区间0.06，0.6）的可能性较小。
定期收集的HRQoL数据可以识别有长期未满足需求风险的幸存者。这些信息对于针对性地提供服务以优化中风后的结局很重要。
