Chen Qi, Cao Chunni, Gong Li, Zhang Yanxiang
Department of Neurology.
Department of Hyperbaric Oxygen, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong Province, China.
Medicine (Baltimore). 2019 Apr;98(16):e15130. doi: 10.1097/MD.0000000000015130.
To clarify dynamic change of quality of life (QOL) in patients with stroke after treatment, and to explore the predictors associated with return to work (RTW) within 48 weeks.Patients diagnosed with stroke were enrolled. All patients enrolled were asked to fill in the Short Form 36 Health Survey. For patients with stroke, SF-36 questionnaires were measured repeatedly 4 weeks after treatment. We used phone call to find out if the patient was RTW. The investigation time was 48 weeks.Patients with stroke had lower scores in terms of physiological dimensions, such as physical functional, role limitations due to physical problems, and general health (P < .001). While patients with strokes scored significantly lower in all mental dimensions including vitality, social functioning, role limitations due to emotional problems, and mental health (P < .001). After 4-weeks treatment, we found that, except for bodily pain, scores in dimensions like physical functioning, role limitations due to physical problems, and general health had increased significantly (P < .001). Multivariate logistic regression analysis was conducted, and the result showed that older age (P = .04) and singleness (P = .03) were risk factors associated with QOL improvement in stroke patients after treatment. Outcomes of stroke patients within 48 weeks were explored. The results showed that 108 out of 136 patients RTW within 48 weeks. Average days it took for patients with cerebral infarction to return to work were 77 ± 79, significantly less than patients with cerebral hemorrhage (206 ± 159 days) and patients with subarachnoid hemorrhage (117 ± 113 days, P < .001). Multivariate analysis indicated that only QOL improvement (P = .04) and subtype of stroke (P = .01) were independent factors associated with RTW within 48 weeks.QOL of stroke patients was significantly reduced. After treatments, the physiological quality of stroke patients increased, but the psychological quality remained low. In addition, patients with cerebral hemorrhage and patients with no significant improvement in QOL are independent risk factors for RTW. Therefore, for this subgroup of the population, early diagnosis, close follow-up and monitor of the psychological state should be provided to avoid the occurrence of adverse events.
为阐明脑卒中患者治疗后生活质量（QOL）的动态变化，并探索与48周内重返工作岗位（RTW）相关的预测因素。纳入诊断为脑卒中的患者。所有纳入患者均被要求填写简短健康调查问卷36项版本（SF-36）。对于脑卒中患者，在治疗后4周重复测量SF-36问卷。我们通过电话询问了解患者是否重返工作岗位。调查时间为48周。脑卒中患者在生理维度方面得分较低，如身体功能、因身体问题导致的角色受限和总体健康状况（P<0.001）。而脑卒中患者在所有心理维度上得分均显著较低，包括活力、社会功能、因情感问题导致的角色受限和心理健康（P<0.001）。经过4周治疗后，我们发现，除身体疼痛外，身体功能、因身体问题导致的角色受限和总体健康状况等维度的得分显著提高（P<0.001）。进行多因素逻辑回归分析，结果显示年龄较大（P=0.04）和单身（P=0.03）是治疗后脑卒中患者生活质量改善的危险因素。探索了脑卒中患者48周内的转归。结果显示，136例患者中有108例在48周内重返工作岗位。脑梗死患者重返工作岗位的平均天数为77±79天，显著少于脑出血患者（206±159天）和蛛网膜下腔出血患者（117±113天，P<0.001）。多因素分析表明，只有生活质量改善（P=0.04）和脑卒中亚型（P=0.01）是与48周内重返工作岗位相关的独立因素。脑卒中患者的生活质量显著降低。治疗后，脑卒中患者的生理质量有所提高，但心理质量仍然较低。此外，脑出血患者和生活质量无显著改善的患者是重返工作岗位的独立危险因素。因此，对于这一亚组人群，应提供早期诊断、密切随访并监测其心理状态，以避免不良事件的发生。
