Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China.
Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People's Republic of China.
J Psychosom Res. 2023 Oct;173:111466. doi: 10.1016/j.jpsychores.2023.111466. Epub 2023 Aug 18.
The relationship between quality of life (QoL) and long-term prognosis in stroke patients is still unclear. We explored physical and mental QoL trajectories during the first six months after stroke and determined the associations between trajectories and long-term prognosis in patients with first-ever ischemic stroke.
Included were 733 participants from a prospective study. QoL was assessed with the 12-item Short Form Survey (SF-12) at baseline, 3 and 6 months. Patients' prognoses (stroke recurrence and death) were identified from 2010 to 2021. The latent class growth model (LCGM) was used to identify distinct trajectories of physical and mental QoL measured over the first 6 months. We employed the Cox model or Fine-Gray model for prognoses to examine the associations between QoL trajectories and prognosis.
Five trajectories of physical QoL and five trajectories of mental QoL were identified. For physical QoL of the Poor-Improved, and Moderate-Impaired trajectory versus Moderate-Improved trajectory, the hazard ratio (HR) for death was 2.39 (1.14 to 5.02), and 2.03(0.93 to 4.44); the HR for recurrence was 1.56 (0.83 to 2.94) and 2.33 (1.28 to 4.24). For mental QoL of the Moderate-Impaired trajectory versus the Moderate-Improved trajectory, the HR for death was 2.48 (1.21 to 5.07). The results were robust in the sensitivity analysis.
QoL during the first six months after ischemic stroke can be categorized into distinct groups. Change in QoL was associated with long-term survival. Secondary prevention of recurrent strokes might rely more on improving patients' physical QoL.
生活质量（QoL）与中风患者长期预后之间的关系仍不清楚。我们探讨了中风后 6 个月内的身心 QoL 轨迹，并确定了首次缺血性中风患者轨迹与长期预后之间的关联。
本研究纳入了一项前瞻性研究中的 733 名参与者。在基线、3 个月和 6 个月时使用 12 项简短健康调查量表（SF-12）评估 QoL。从 2010 年到 2021 年，确定了患者的预后（中风复发和死亡）。使用潜在类别增长模型（LCGM）来识别前 6 个月身心 QoL 的不同轨迹。我们使用 Cox 模型或 Fine-Gray 模型进行预后分析，以检验 QoL 轨迹与预后之间的关系。
确定了 5 种身体 QoL 轨迹和 5 种心理 QoL 轨迹。对于身体 QoL 的 Poor-Improved 和 Moderate-Impaired 轨迹与 Moderate-Improved 轨迹相比，死亡的风险比（HR）分别为 2.39（1.14 至 5.02）和 2.03（0.93 至 4.44）；复发的 HR 分别为 1.56（0.83 至 2.94）和 2.33（1.28 至 4.24）。对于心理 QoL 的 Moderate-Impaired 轨迹与 Moderate-Improved 轨迹相比，死亡的 HR 为 2.48（1.21 至 5.07）。敏感性分析结果稳健。
缺血性中风后 6 个月内的 QoL 可分为不同的组别。QoL 的变化与长期生存相关。复发中风的二级预防可能更多地依赖于改善患者的身体 QoL。
