Zhou Jiting, Wei Qiran, Hu Hongfei, Liu Wei, Guan Xin, Ma Aixia, Wang Luying
School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, China.
Front Neurol. 2023 Sep 5;14:1219679. doi: 10.3389/fneur.2023.1219679. eCollection 2023.
Ischemic stroke (IS) has a considerable impact on the health-related quality of life (HRQoL) of patients. A systematic review was conducted to summarize and synthesize the HRQoL reported from IS patients.
An electronic search was performed in PubMed, Web of Science, ScienceDirect, Embase, and Cochrane Library databases from inception to February 2022 for studies measuring utility values in IS patients. Basic information about the studies, patient characteristics, measurement of the utility values, and utility values were extracted and summarized. Utility values were pooled according to the time of evaluation, and disease severity was classified with modified Rankin Scale (mRS) scores. The quality of the studies was assessed according to key criteria recommended by the National Institute for Health and Care Excellence.
A total of 39 studies comprising 30,853 participants were included in the study. Measured with EQ-5D-3L, the pooled utility values were 0.42 [95% confidential interval (CI): 0.13 to 0.71], 0.55 (95% CI: 0.43 to 0.68), 0.65 (95% CI: 0.52 to 0.78), 0.60 (95% CI: 0.43 to 0.78), and 0.67 (95% CI: 0.60 to 0.74) for patients diagnosed with IS within 1, 3, 6, 12, and 24 months or above among poststroke patients. Four studies reported utility values classified by mRS scores where synthesized estimates stratified by mRS scores ranged from 0.91 (95% CI: 0.85 to 0.97) for patients with an mRS score of 1 to-0.04 (95% CI:-0.18 to 0.11) for those with an mRS score of 5. As for the health dimension profiles, usual activity was the most impacted dimension, while self-care was the least impacted one.
This study indicated that the utility values in IS patients kept increasing from stroke onset and became relatively stabilized at 6 months poststroke. Health utility values decreased significantly as mRS scores increased. These results facilitate economic evaluations in utility retrieval and selection. Further exploration was required regarding the factors that affect the HRQoL of IS patients.
缺血性中风（IS）对患者的健康相关生活质量（HRQoL）有相当大的影响。进行了一项系统综述，以总结和综合IS患者报告的HRQoL。
在PubMed、Web of Science、ScienceDirect、Embase和Cochrane图书馆数据库中进行电子检索，检索时间从数据库建立至2022年2月，以查找测量IS患者效用值的研究。提取并总结了有关研究的基本信息、患者特征、效用值测量方法和效用值。根据评估时间汇总效用值，并使用改良Rankin量表（mRS）评分对疾病严重程度进行分类。根据英国国家卫生与临床优化研究所推荐的关键标准评估研究质量。
该研究共纳入39项研究，包括30853名参与者。使用EQ-5D-3L测量，中风后1、3、6、12和24个月或更长时间内被诊断为IS的患者的汇总效用值分别为0.42 [95%置信区间（CI）：0.13至0.71]、0.55（95% CI：0.43至0.68）、0.65（95% CI：0.52至0.78）、0.60（95% CI：0.43至0.78）和0.67（95% CI：0.60至0.74）。四项研究报告了按mRS评分分类的效用值，其中按mRS评分分层的综合估计值范围为mRS评分为1的患者为0.91（95% CI：0.85至0.97），mRS评分为5的患者为-0.04（95% CI：-0.18至0.11）。至于健康维度概况，日常活动是受影响最大的维度，而自我护理是受影响最小的维度。
本研究表明，IS患者的效用值从中风发作开始持续增加，并在中风后6个月相对稳定。随着mRS评分增加，健康效用值显著下降。这些结果有助于效用检索和选择中的经济评估。需要进一步探索影响IS患者HRQoL的因素。
