Lens Charlotte, Demeestere Jelle, Vanhaecht Kris, Lemmens Robin
Department of Neurology, University Hospitals Leuven, Leuven, Belgium.
Department of Neurosciences, Experimental Neurology, KU Leuven - University of Leuven, Leuven, Belgium.
Front Neurol. 2021 Jan 22;11:630850. doi: 10.3389/fneur.2020.630850. eCollection 2020.
The modified Rankin Scale (mRS) after 90 days documents outcome in stroke patients, but focusses only on activities of daily living. Here we studied stroke outcome beyond these activities by the Dutch-Flemish version of the Patient Reported Outcomes Measurement Information System (PROMIS) questionnaire. We documented the mRS at day 90 in stroke patients who filled out a questionnaire on pain intensity and seven PROMIS domains: physical function, ability to participate in social roles, anxiety, fatigue, depression, sleep disturbance, pain interference. In a subgroup of patients this questionnaire was reduced to one overall question per PROMIS domain. We correlated these findings with the mRS. We received 102 questionnaires and identified physical function as the most affected PROMIS domain. The strongest correlation with mRS was found for the health domains of physical function (ρs = 0.70, < 0.001) and ability to participate in social roles (ρs = 0.61, < 0.001). The other domains with substantial proportions of patients with worse scores compared to the general population (19-44%) correlated weakly with the mRS. We identified a strong correlation between the single question per health domain and the overall score per PROMIS domain. PROMIS better reflects the overall health status of stroke patients beyond functional outcome as measured by the mRS. Simplification of the questionnaire with a single question per PROMIS domain could potentially replace the full questionnaire, but needs further validation.
改良Rankin量表（mRS）用于记录卒中患者90天后的预后情况，但仅关注日常生活活动。在此，我们通过荷兰-弗拉芒语版的患者报告结局测量信息系统（PROMIS）问卷研究了这些活动之外的卒中预后。我们记录了填写疼痛强度问卷以及七个PROMIS领域（身体功能、参与社会角色的能力、焦虑、疲劳、抑郁、睡眠障碍、疼痛干扰）问卷的卒中患者90天时的mRS。在一组患者中，该问卷简化为每个PROMIS领域一个总体问题。我们将这些结果与mRS进行了关联分析。我们收到了102份问卷，并确定身体功能是受影响最大的PROMIS领域。身体功能（ρs = 0.70，< 0.001）和参与社会角色的能力（ρs = 0.61，< 0.001）这两个健康领域与mRS的相关性最强。与一般人群相比，其他领域中得分较差的患者比例较高（19 - 44%），与mRS的相关性较弱。我们发现每个健康领域的单个问题与每个PROMIS领域的总体得分之间存在很强的相关性。与mRS所衡量的功能结局相比，PROMIS能更好地反映卒中患者的整体健康状况。将问卷简化为每个PROMIS领域一个问题可能会取代完整问卷，但需要进一步验证。
