卒中幸存者的健康相关生活质量：哥德堡跌倒研究（FallsGOT）的 5 年随访。
Health-related quality of life in stroke survivors: a 5-year follow-up of The Fall Study of Gothenburg (FallsGOT).
机构信息
Department of Internal Medicine, Nyköping Hospital, Region Sörmland, Nyköping, Sweden.
Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
出版信息
BMC Geriatr. 2023 Sep 22;23(1):584. doi: 10.1186/s12877-023-04308-z.
BACKGROUND
There are limited data on long-term prevalence and predictors of health-related quality of life (HRQoL) in stroke survivors. Therefore, the aim was to describe the prevalence of impaired HRQoL, and to identify factors in acute stroke that are associated with impaired HRQoL, 5 years after stroke.
METHODS
The 305 (60.5%) stroke survivors of the original 504 participants from The Fall Study of Gothenburg were invited to participate in a 5-year follow-up including assessment of HRQoL using the EuroQol 5 Dimensions 3 Levels questionnaire (EQ-5D-3L). To identify baseline predictors of impaired HRQoL, based on the EQ-5D-3L's five dimensions, univariate and multivariate logistic regression analyses were performed.
RESULTS
A total of 129 participants (42.3% of the survivors) completed the questionnaire at a median follow-up time of 58 months. At baseline, their mean age was 70.6 years, and they had a median NIHSS score of 1. The median (interquartile range [IQR]) EQ-5D-3L index score was 0.87 (0.71-0.93) and the median (IQR) EQ-visual analogue scale was 70 (49.8-88). In total, 102 (79%) participants were classified as having impaired HRQoL, stated primarily (among 68.5%) related to Pain/Discomfort. Higher age was identified as a predictor of impaired HRQoL related to Mobility (Odds ratio (OR) 1.05, 95% confidence interval (CI) 1.01-1.10) and Self-Care (OR 1.09, 95% CI 1.02-1.17), and longer hospital stay at baseline was identified as a predictor related to Mobility (OR 1.09, 95% CI 1.01-1.18), Self-Care (OR 1.10, 95% CI 1.02-1.18)) and Usual Activities. (OR 1.10, 95% CI 1.03-1.18).
CONCLUSION
At 5 years after stroke, four out of five participants (79%) reported impaired HRQoL related to any of the five dimensions assessed by using the EQ-5D-3L. Most reported, impaired HRQoL was related to Pain/Discomfort. Higher age and longer hospital care period at index stroke were associated with impaired HRQoL. The findings could assist to identify individuals at high risk of low HRQoL, who might benefit from special attention and psychological support.
背景
关于中风幸存者的健康相关生活质量（HRQoL）的长期流行率和预测因素的数据有限。因此，本研究旨在描述中风后 5 年中风幸存者的 HRQoL 受损的流行率，并确定与急性中风相关的 HRQoL 受损的因素。
方法
在最初的 504 名参与者中，有 305 名（60.5%）中风幸存者被邀请参加一项 5 年随访，包括使用 EuroQol 5 维度 3 水平问卷（EQ-5D-3L）评估 HRQoL。为了确定基于 EQ-5D-3L 的五个维度的 HRQoL 受损的基线预测因素，进行了单变量和多变量逻辑回归分析。
结果
共有 129 名参与者（幸存者的 42.3%）完成了中位随访时间为 58 个月的问卷调查。基线时，他们的平均年龄为 70.6 岁，NIHSS 评分为 1。EQ-5D-3L 指数得分的中位数（四分位距 [IQR]）为 0.87（0.71-0.93），EQ-视觉模拟量表的中位数（IQR）为 70（49.8-88）。共有 102 名（79%）参与者被归类为 HRQoL 受损，主要（占 68.5%）与疼痛/不适有关。较高的年龄被确定为与移动性（优势比 [OR] 1.05，95%置信区间 [CI] 1.01-1.10）和自我护理（OR 1.09，95% CI 1.02-1.17）相关的 HRQoL 受损的预测因素，而基线时较长的住院时间被确定为与移动性（OR 1.09，95% CI 1.01-1.18）、自我护理（OR 1.10，95% CI 1.02-1.18）和日常活动（OR 1.10，95% CI 1.03-1.18）相关的预测因素。
结论
中风后 5 年，五分之四（79%）的参与者使用 EQ-5D-3L 评估的五个维度中的任何一个维度报告了 HRQoL 受损。大多数报告的 HRQoL 受损与疼痛/不适有关。较高的年龄和指数中风时较长的住院时间与 HRQoL 受损相关。这些发现可以帮助识别 HRQoL 低风险较高的个体，他们可能受益于特别关注和心理支持。
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