From the Neurological Institute Center for Outcomes Research & Evaluation (I.L.K., N.R.T., B.L.), and Cerebrovascular Center (I.L.K., K.U.), Cleveland Clinic, OH.
Neurology. 2018 Apr 17;90(16):e1364-e1371. doi: 10.1212/WNL.0000000000005327. Epub 2018 Mar 28.
(1) Examine 8 patient-reported domains of health across levels of disability compared to the US general population; and (2) identify factors associated with domain scores in patients with ischemic stroke.
Observational cohort study of 1,195 patients in a cerebrovascular clinic from February 17, 2015, to January 27, 2017, who completed Neuro-QoL (Quality of Life in Neurological Disorders) executive function or the following PROMIS (Patient-Reported Outcomes Measurement Information System) scales as part of routine care: physical function, satisfaction with social roles, fatigue, anxiety, depression, pain interference, and sleep disturbance.
Mean age was 62 (±15) years, and 81% were white. Median modified Rankin Scale (mRS) score at the clinic visit was 1 (interquartile range 0-2). Percentage of patients with scores meaningfully worse than the general population ranged from 28% (sleep disturbance) to 63% (physical function). Scores were worse in patients with higher mRS levels, although correlation between scores and mRS level varied (sleep disturbance = 0.16 to physical function = 0.52). Most affected domains were physical function (T score = 58.8), satisfaction with social roles (T score = 55.4), and executive function (T score = 53.4). Disability, lower income, and female sex were associated with worse scores in multiple domains. Age was associated with worse physical function but lower anxiety, depression, and sleep disturbance.
Patients with ischemic stroke reported symptoms in multiple domains that increase to variable degrees at higher levels of disability. Physical function, satisfaction with social roles, and executive function were most affected. This information improves our understanding of the well-being of patients with ischemic stroke and brings attention to the importance of social roles and executive function for stroke survivors.
（1）比较残疾程度不同的患者与美国一般人群之间的 8 个患者报告的健康领域；（2）确定与缺血性卒中患者领域评分相关的因素。
对 2015 年 2 月 17 日至 2017 年 1 月 27 日期间在脑血管病诊所接受治疗的 1195 名患者进行观察性队列研究，这些患者完成了神经 QoL（神经疾病患者生活质量）执行功能或以下 PROMIS（患者报告的结果测量信息系统）量表作为常规护理的一部分：身体功能、社会角色满意度、疲劳、焦虑、抑郁、疼痛干扰和睡眠障碍。
平均年龄为 62（±15）岁，81%为白人。就诊时中位数改良 Rankin 量表（mRS）评分为 1（四分位距 0-2）。评分明显差于一般人群的患者比例为 28%（睡眠障碍）至 63%（身体功能）。mRS 水平较高的患者评分较差，尽管评分与 mRS 水平之间的相关性不同（睡眠障碍为 0.16，身体功能为 0.52）。受影响最严重的领域是身体功能（T 评分=58.8）、社会角色满意度（T 评分=55.4）和执行功能（T 评分=53.4）。残疾、较低的收入和女性与多个领域的较差评分相关。年龄与身体功能较差相关，但与焦虑、抑郁和睡眠障碍程度较低相关。
缺血性卒中患者报告了多个领域的症状，随着残疾程度的增加，这些症状的严重程度不同。身体功能、社会角色满意度和执行功能受影响最严重。这些信息提高了我们对缺血性卒中患者的幸福感的理解，并引起了对卒中幸存者的社会角色和执行功能的重视。
