Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen Medical Center, Göttingen, Germany; Department of Thoracic- und Cardiovascular Surgery, University of Göttingen Medical Center, Göttingen, Germany; DZHK (German Center for Cardiovascular Research), Partner site Göttingen, Germany.
Department of Neurology, University of Göttingen Medical Center, Göttingen, Germany.
J Psychosom Res. 2021 Mar;142:110353. doi: 10.1016/j.jpsychores.2020.110353. Epub 2021 Jan 2.
Stroke can negatively impact the health-related quality of life (HRQoL). Anxiety or depression after stroke have been associated with poorer HRQoL, higher mortality and greater dependence in activities of daily living. We aimed to analyze HRQoL, anxiety and depressive symptoms in patients with and without atrial fibrillation (AF) up to 12 months post-stroke.
Find-AF was a prospective, randomized multicenter study, which included 398 patients ≥60 years with acute cerebral ischemia. HRQoL data were collected using the 3-level EuroQol-5D (EQ-5D-3L) and Stroke Impact Scale (SIS-16). Anxiety and depressive symptoms were measured using the Hospital Anxiety and Depression Scale (HADS). The severity of stroke was measured using the modified Rankin Scale (mRS).
In this study (mean age 72.7 ± 7.5 years, 40.2% females), there was a significant improvement in HRQoL using EQ-5D-3L after 3 months (β = 0.37, p < .01), 6 months (β = 0.43, p < .01) and 12 months (β = 0.44, p < .01) post-stroke compared to baseline. HADS anxiety scores after 3 months (β = -0.22, p < .01) and 12 months (β = -0.28, p < .01) were significantly reduced. Older patients reported reduced HRQoL and more depressive symptoms. Females indicated lower HRQoL and more anxiety. mRS score at baseline was an independent predictor for HRQoL. There was a significant but small effect of AF on EQ-5D-3L and on HADS anxiety.
Patients showed significant improvement in HRQoL and reduced anxiety after 3 and 12 months after stroke. We could demonstrate that the severity of stroke as well as sex and age impact long-term post-stroke HRQoL.
Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01855035.
中风会对健康相关生活质量（HRQoL）产生负面影响。中风后出现的焦虑或抑郁与较差的 HRQoL、更高的死亡率和更大的日常生活活动依赖有关。我们旨在分析中风后 12 个月内伴有和不伴有心房颤动（AF）的患者的 HRQoL、焦虑和抑郁症状。
Find-AF 是一项前瞻性、随机多中心研究，纳入了 398 名年龄≥60 岁的急性脑缺血患者。使用 3 级欧洲五维健康量表（EQ-5D-3L）和中风影响量表（SIS-16）收集 HRQoL 数据。使用医院焦虑和抑郁量表（HADS）测量焦虑和抑郁症状。使用改良 Rankin 量表（mRS）测量中风的严重程度。
在这项研究中（平均年龄 72.7±7.5 岁，40.2%为女性），与基线相比，中风后 3 个月（β=0.37，p<.01）、6 个月（β=0.43，p<.01）和 12 个月（β=0.44，p<.01）使用 EQ-5D-3L 后 HRQoL 显著改善。中风后 3 个月（β=-0.22，p<.01）和 12 个月（β=-0.28，p<.01）的 HADS 焦虑评分显著降低。年龄较大的患者报告 HRQoL 降低和更多的抑郁症状。女性的 HRQoL 较低，焦虑症状更多。基线 mRS 评分是 HRQoL 的独立预测因素。AF 对 EQ-5D-3L 和 HADS 焦虑有显著但较小的影响。
中风后 3 个月和 12 个月后，患者的 HRQoL 显著改善，焦虑减轻。我们能够证明中风的严重程度以及性别和年龄对中风后长期 HRQoL 有影响。
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