Department of Neurology and Neuroscience, Faculty of Medicine, Medical University "Prof. Paraskev Stoyanov", Varna, Bulgaria.
Second Clinic of Neurology with ICU and Stroke Unit, University Multiprofile Hospital for Active Treatment "St. Marina", Varna, Bulgaria.
Neurol Res. 2021 Jul;43(7):553-561. doi: 10.1080/01616412.2021.1893563. Epub 2021 Feb 26.
Ischemic stroke (IS) is one of the leading causes of death and long-term disability in Bulgaria. IS affects different aspects of the patient's life and results in loss of independence and poor health-related quality of life (HR-QoL). We aimed to analyze the impact of IS on HR-QoL and to identify possible associations with sociodemographic, clinical features, and vascular risk factors (RF).
A prospective, hospital-based study was undertaken from 1 July 2019 to 31 June 2020, at a tertiary care referral center for neurological disorders in Bulgaria. A total of 150 patients with acute IS - 50 with thrombolytic and 100 with non-thrombolytic therapy - were included. Thorough clinical and sociodemographic data were collected. The NIHSS scale determined stroke severity, and HR-QoL was assessed with the Stroke Impact Scale Version 3.0 (SIS 3.0) during the first 3 months.
The overall HR-QoL improved during the observation period, but still, it remained significantly worse. The major predictors of a marked reduction in HR-QoL were age, female sex, lower education level, and actively working at stroke onset, high NIHSS score, anterior circulation stroke, and more extended hospital. Atrial fibrillation and heart failure were significantly associated with poor HR-QoL. The other investigated vascular risk factors were associated with different extends with poorer HR-QoL, except for dyslipidemia.
Stroke survivors have significantly reduced HR-QoL. Multiple interacting factors are associated with an unfavorable outcome after IS. Early detection of these factors would help to improve the care for IS patients, to reduce disabilities and improve HR-QoL.
缺血性脑卒中（IS）是保加利亚主要的致死和致残原因之一。IS 影响患者生活的多个方面，导致其丧失独立性和健康相关生活质量（HR-QoL）较差。我们旨在分析 IS 对 HR-QoL 的影响，并确定与社会人口学、临床特征和血管危险因素（RF）相关的可能关联。
本前瞻性、基于医院的研究于 2019 年 7 月 1 日至 2020 年 6 月 31 日在保加利亚的一家三级神经疾病转诊中心进行。共纳入 150 例急性 IS 患者——50 例溶栓治疗和 100 例非溶栓治疗，收集了全面的临床和社会人口学数据。NIHSS 量表确定卒中严重程度，在发病后的前 3 个月内使用卒中影响量表 3.0 版（SIS 3.0）评估 HR-QoL。
在观察期间，整体 HR-QoL 有所改善，但仍明显较差。HR-QoL 明显下降的主要预测因素是年龄、女性、较低的教育水平、发病时从事有薪工作、较高的 NIHSS 评分、前循环卒中以及更长的住院时间。房颤和心力衰竭与较差的 HR-QoL 显著相关。其他调查的血管危险因素与较差的 HR-QoL 存在不同程度的关联，除了血脂异常。
卒中幸存者的 HR-QoL 显著降低。多种相互作用的因素与 IS 后的不良预后相关。早期发现这些因素将有助于改善 IS 患者的护理，减少残疾并提高 HR-QoL。
