Long-term health-related quality of life, survival and costs by different levels of functional outcome six months after stroke.

INTRODUCTION

Information about the impact of functional outcome after stroke is currently missing on health-related quality of life, survival and costs. This information would be valuable for health economic evaluations and for allocation of resources in stroke health care.

PATIENTS AND METHODS

Data on 297 Swedish patients included in the Third International Stroke Trial were analysed including functional outcome at six months (measured by Oxford Handicap Scale), health-related quality of life up to 18 months (EQ-5D-3L) and survival up to 36 months. We used record linkage to collect data on costs up to 36 months, using national patient registers.

RESULTS

Patients with a better functional outcome level at six months had a significantly better health-related quality of life at 18 months ( < 0.05), better long-term survival ( < 0.05) and lower costs ( < 0.001), for all time points up to 36 months. The difference in costs was mainly due to differences in days spent in hospital ( < 0.005).

DISCUSSION

This study showed an association between functional outcome at six months and health-related quality of life up to 18 months, and costs up to 36 months.

CONCLUSION

Functional outcome six months after stroke is an important determinant of health-related quality of life, survival and costs over 36 months. Effective interventions aimed at reducing short-term disability levels are therefore also expected to reduce the overall burden of stroke.