Correlation between risk factors, functional recovery, and the health-related quality of life of stroke survivors

Abstract

Introduction/Objective It has been estimated that 50% of strokes are preventable through the control of modifiable risk factors. The objective of the paper was to determine the correlation between the risk factors, functional status, and the health-related quality of life (HRQOL) of stroke survivors. Method The prospective cohort study was used. The study included 136 patients 30-79 years old. Functional recovery was assessed using the Barthel index (BI) and the Modified Rankin Scale (mRS). The HRQOL was evaluated by the generic Short Form 36 (SF-36) questionnaire. BI and mRS were determined at admission at the rehabilitation, one, three and six months after the stroke. The SF-36 was filled out at the same time. The analysis of the repeated measure variance (Repeated Measures ANOVA) was applied, as well as the correlation analysis and Spearman's coefficient of rank correlation. Results A total number of 136 patients [66 (48.5%) male and 70 (51.5%) female] completed the questionnaire. The average age of stroke survivors was 63.72 ± 8.73. At admission, mRS was 4.75 ± 0.55, and six months after the stroke onset it decreased to 2.60 ± 1.08. The average value of BI at admission was 25 ± 24.66, and within six months it increased to 83.75 ± 18.59 (p = 0.001). The ANOVA showed that the values of mRS significantly decreased (p < 0.001) and the values of BI significantly increased (ANOVA: p < 0.001). All domains of the SF-36 questionnaire, except for the pain domain, significantly increased (p < 0.001). The physical function (r = 0.238; p < 0. 01), physical role (r = 0.199; p < 0.05), and emotional role (r = 0.237; p < 0.01) were significantly lower among alcohol addicts (r = 0.199; p < 0.05). Mental health (r = 0.244; p < 0.01) and social relationships domains were significantly lower among smokers (r = 0.272; p < 0.01). The general health (r =-0.290; p < 001) and health condition change domains were significantly lower among smokers (r = 0.225; p < 0.01). Conclusion The most important risk factor which was negatively correlated with the HRQOL was smoking. The patients who were smokers and alcohol addicts had a significantly smaller increase of the HRQOL domains compared to other patent groups. Six months after the stroke, all domains of the HRQOL significantly increased. The significant improvement of patients' functional status was positively correlated to the increase of their HRQOL.

How much is the patient's quality of life impaired in the early stages of stroke?

“…Kvalitet života povezan sa zdravljem -Health-related quality of life (HRQoL) odnosi se na aspekte kvaliteta života pogođene bolešću ili uticaj zdravstvenog stanja na subjektivnu percepciju ispitanika [17]. Procena HRQoL koristi se u izradi individualnih planova lečenja pacijenata, sprovođenju analiza troškova i koristi, donošenju odluka o zdravstvenoj politici i sprovođenju kliničkih ispitivanja [18].…”