Health Services Research Unit, Akershus University Hospital, PO Box 1000, 1478, Lørenskog, Norway.
Department of Health Management and Health Economics, Medical Faculty, University of Oslo, Oslo, Norway.
Qual Life Res. 2020 Oct;29(10):2679-2693. doi: 10.1007/s11136-020-02516-3. Epub 2020 May 9.
To describe the health-related quality of life (HRQoL) of caregivers and survivors of transient ischaemic attack (TIA) and stroke during one year post discharge in comparison to age- and sex-matched population norms; and to analyse the association of initial stroke severity, measured by a routinely used stroke-specific scale, on subsequent HRQoL of caregivers and survivors.
Cohort of hospitalized patients with TIA and stroke discharged alive from a large university hospital in Norway, and their informal caregivers. Questionnaires at 3 and 12 months post discharge were filled out by caregivers (n = 320 and n = 326, respectively) and survivors (n = 368 and n = 383, respectively). Multivariable linear regression analyses tested associations between initial stroke severity (National Institutes of Health Stroke Scale, NIHSS) and HRQoL (EQ-5D-3L) in caregivers and survivors.
Caregivers of survivors with TIA or stroke did not report lower HRQoL than matched norms. There was some evidence of an association of the NIHSS with caregiver HRQoL at 3 months only (age-sex-adjusted coefficient - 0.01, p = 0.008), however, this was attenuated after additional adjustments. Survivors with stroke, but not TIA, reported lower HRQoL than population norms at both time points. There was a negative association between higher NIHSS scores and survivors' HRQoL; fully adjusted coefficient - 0.01 at both time points (p = 0.001).
The informal caregivers and survivors with TIA did not report lower than expected HRQoL. Increasing stroke severity was associated with decreasing HRQoL among survivors, but had limited predictive value among caregivers. Other factors may therefore be better indicators of 'at risk' caregivers.
描述短暂性脑缺血发作（TIA）和脑卒中出院后 1 年内照顾者和幸存者的健康相关生活质量（HRQoL）与年龄和性别匹配的人群正常值的比较；并分析初始卒中严重程度（通过常规使用的卒中特异性量表测量）与照顾者和幸存者随后的 HRQoL 的相关性。
该队列包括从挪威一家大型大学医院出院的 TIA 和脑卒中住院患者及其非正式照顾者。照顾者（分别为 n=320 和 n=326）和幸存者（分别为 n=368 和 n=383）在出院后 3 个月和 12 个月时填写问卷。多变量线性回归分析测试了初始卒中严重程度（国立卫生研究院卒中量表，NIHSS）与照顾者和幸存者 HRQoL（EQ-5D-3L）之间的关系。
TIA 或脑卒中幸存者的照顾者报告的 HRQoL 并不低于匹配的正常值。仅在 3 个月时，NIHSS 与照顾者 HRQoL 之间存在一定的关联（年龄-性别调整后的系数-0.01，p=0.008），但在进一步调整后，这种关联减弱了。只有脑卒中幸存者，而不是 TIA 幸存者，在两个时间点都报告了低于人群正常值的 HRQoL。NIHSS 评分越高，与幸存者的 HRQoL 呈负相关；在两个时间点均完全调整后的系数为-0.01（p=0.001）。
TIA 的非正式照顾者和幸存者报告的 HRQoL 并不低于预期。卒中严重程度的增加与幸存者的 HRQoL 下降有关，但在照顾者中预测价值有限。因此，其他因素可能是“高危”照顾者的更好指标。
