Jeon Na Eun, Kwon Kyoung Min, Kim Yeo Hyung, Lee Jung Soo
Department of Rehabilitation Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea.
Ann Rehabil Med. 2017 Oct;41(5):743-752. doi: 10.5535/arm.2017.41.5.743. Epub 2017 Oct 31.
To evaluate the association between clinical and socio-demographic status and health-related quality of life (HR-QoL) in stroke survivors age 40 and older in the Korean population.
The relationship between stroke and HR-QoL was investigated using data from the Korea National Health and Nutrition Examination Survey (KNHANES), conducted from 2007-2012. The total number of respondents was 24,050 and 757 stroke survivors were included. Specifically, we investigated factors associated with the lowering of HR-QoL in a group of Korean adult stroke patients age 40 and older after adjusting for socio-demographic factors, anthropometric measurements, and clinical comorbidities. Adjusted effects of covariates on EuroQol-visual analog scales (EQ-VAS) scores were estimated with a complex-samples general linear model and multivariate-adjusted odds ratios of the lowest quintile versus highest quintile of the EQ-VAS scores in the stroke group were estimated with a complex-samples logistic regression model.
Socio-demographic, anthropometric factors, and clinical comorbidities significantly differed between the stroke and non-stroke groups, except regarding gender and residential area. The EQ-VAS was significantly lower in the stroke than non-stroke group. Anxiety/depression problems significantly lowered EQ-VAS, as did low education level, smoking, mobility and usual activities problems. Also, aging in 1-year increments and cardiovascular disease had a significant effect on lower EQ-VAS in stroke survivors.
People with a stroke have significantly lower HR-QoL than healthy subjects. Therefore, managing depression, smoking, or cardiovascular disease and maintenance of physical function may be priority goals in improving HR-QoL after a stroke.
评估韩国40岁及以上中风幸存者的临床和社会人口学状况与健康相关生活质量(HR-QoL)之间的关联。
利用2007年至2012年韩国国家健康与营养检查调查(KNHANES)的数据,研究中风与HR-QoL之间的关系。总受访者人数为24,050人,其中包括757名中风幸存者。具体而言,在调整社会人口学因素、人体测量指标和临床合并症后,我们调查了一组40岁及以上韩国成年中风患者中与HR-QoL降低相关的因素。使用复杂样本一般线性模型估计协变量对欧洲五维度健康量表视觉模拟评分(EQ-VAS)得分的调整效应,并使用复杂样本逻辑回归模型估计中风组中EQ-VAS得分最低五分位数与最高五分位数的多变量调整比值比。
除性别和居住地区外,中风组和非中风组在社会人口学、人体测量因素和临床合并症方面存在显著差异。中风组的EQ-VAS得分显著低于非中风组。焦虑/抑郁问题、低教育水平、吸烟、行动能力和日常活动问题均显著降低了EQ-VAS得分。此外,年龄每增加1岁以及患有心血管疾病对中风幸存者的EQ-VAS得分降低有显著影响。
中风患者的HR-QoL显著低于健康受试者。因此,管理抑郁、吸烟或心血管疾病以及维持身体功能可能是中风后改善HR-QoL的首要目标。