Self-perceived impact of stroke: A longitudinal comparison between one and five years post-stroke

Skoglund, Erik; Westerlind, Emma; Persson, Hanna; Sunnerhagen, Katharina S.

doi:10.2340/16501977-2595

Cited by 26 publications

(23 citation statements)

References 18 publications

(24 reference statements)

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“…Moreover, mTBI and stroke experienced problems in similar cognitive domains: attention and memory. Persistent symptoms in daily life can impact QoL, as observed in significant percentages reporting problems regarding the QoL domains at 6 months post-injury, and which continue impacting QoL up to 5 years post-injury [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

“…Estimates of cognitive problems vary depending on assessment methods, but persist into the long term in around 50% of mTBI cases [ 14 ] and approximately 35% of minor stroke cases [ 9 ]. Quality of life (QoL) is negatively affected by these persisting symptoms, because of confrontation with difficulties on a daily basis and trouble managing daily activities [ 15 ]. Despite these long-term consequences, coordinated attention for psychosocial symptoms in aftercare is currently missing for both (m)TBI and (minor) strokes.…”

Section: Introductionmentioning

confidence: 99%

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Long-term psychosocial outcome following mild traumatic brain injury and minor stroke: a direct longitudinal comparison

et al. 2021

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Background and purpose Research suggests comparable long-term psychosocial outcomes following mild traumatic brain injury (mTBI) and minor stroke, but no direct comparison has been made. This study aimed to directly compare psychosocial outcome over time in persons with mTBI and minor stroke. Methods In this multicenter, prospective longitudinal cohort study, community-dwelling persons with mTBI (n = 182) and minor stroke (n = 48) were assessed at 6 weeks, 3, 6 and 12 months post-injury. Outcome measures included anxiety and depression symptoms (Hospital Anxiety and Depression Scale—HADS), cognitive problems in daily life (Checklist for Cognitive and Emotional Consequences of Stroke—CLCE-24) and quality of life (EuroQol-5D-5L—EQ-5D-5L). Multilevel growth curve modeling, controlled for demographic variables, was used to determine outcomes over time between groups. Proportions of persons reporting persistent psychosocial symptoms at 6 months post-injury were compared using Pearson’s Chi-squared tests. Results Improvements in outcomes were observed in the first 6 months and effects stabilized to 12 months post-injury in both groups. Minor stroke cases reported significantly higher levels of HADS anxiety and a significantly reduced increase in EQ-5D-5L utility scores than mTBI cases, but differences were small in absolute numbers. No significant differences were observed between groups regarding HADS depression and CLCE-24 cognition scores. Proportions of persons reporting persistent psychosocial symptoms were equal between groups. Conclusions Psychosocial outcome is largely comparable following mTBI and minor stroke. Specific attention should be paid to anxiety symptoms and cognitive problems in daily life for which uniform aftercare seems appropriate.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Long-term psychosocial outcome following mild traumatic brain injury and minor stroke: a direct longitudinal comparison

et al. 2021

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“…Further, perceived impact of stroke has been shown to become more prominent over time, even in the case for persons with mild-to-moderate stroke severity. 32…”

Section: Discussionmentioning

confidence: 99%

Pre-existing Comorbidity Burden and Patient Perceived Stroke Impact

Sewell

Tse

Harris

et al. 2020

International Journal of Stroke

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Background Pre-existing comorbidities can compromise recovery post-stroke. However, the association between comorbidity burden and patient-rated perceived impact has not been systematically investigated. To date, only observer-rated outcome measures of function, disability, and dependence have been used, despite the complexity of the impact of stroke on an individual. Aim Our aim was to explore the association between comorbidity burden and patient-rated perceived impact and overall recovery, within the first-year post-stroke, after adjusting for stroke severity, age, and sex. Methods The sample comprised 177 stroke survivors from 18 hospitals throughout Australia and New Zealand. Comorbidity burden was calculated using the Charlson Comorbidity Index. Perceived impact and recovery were measured by the Stroke Impact Scale index and Stroke Impact Scale overall recovery scale. Quantile regression models were applied to investigate the association between comorbidity burden and perceived impact and recovery. Results Significant negative associations between the Charlson Comorbidity Index and the Stroke Impact Scale index were found at three months. At the .25 quantile, a one-point increase on the Charlson Comorbidity Index was associated with 6.80-points decrease on the Stroke Impact Scale index (95%CI: −11.26, −2.34; p = .003). At the median and .75 quantile, a one-point increase on the Charlson Comorbidity Index was associated, respectively, with 3.58-points decrease (95%CI: −5.62, −1.54; p = .001) and 1.76-points decrease (95%CI: −2.80, −0.73; p = .001) on the Stroke Impact Scale index. At 12 months, at the .25 and .75 quantiles, a one-point increase on the Charlson Comorbidity Index was associated, respectively, with 6.47-points decrease (95%CI: −11.05, −1.89; p = .006) and 1.26-points decrease (95%CI: −2.11, −0.42; p = .004) on the Stroke Impact Scale index. For the Stroke Impact Scale overall recovery measure, significant negative associations were found only at the median at three months and at the .75 quantile at 12 months. Conclusion Comorbidity burden is independently associated with patient-rated perceived impact within the first-year post-stroke. The addition of patient-rated impact measures in personalized rehabilitation may enhance the use of conventional observer-rated outcome measures.

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“…Continued and complex posthospitalization care, including treatment for depression and increased social support, covers the vast financial resources of healthcare [ 4 ]. Moreover, the perceived impact of stroke becomes more prominent with time, even for persons with mild-to-moderate stroke [ 5 ]. There are two main types of stroke leading to focal neurological deficit: ischemic and haemorrhagic stroke, which constitute 80–85% and 10–15% of all strokes, respectively.…”

Section: Introductionmentioning

confidence: 99%

The Role of Resolvins: EPA and DHA Derivatives Can Be Useful in the Prevention and Treatment of Ischemic Stroke

Tułowiecka

Kotlęga

Prowans

2020

IJMS

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Introduction: Most ischemic strokes develop as a result of atherosclerosis, in which inflammation plays a key role. The synthesis cascade of proinflammatory mediators participates in the process induced in the vascular endothelium and platelets. Resolvins are anti-inflammatory mediators originating from eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), which may improve the prognosis related to atherosclerosis by inhibiting the production of proinflammatory cytokines, limiting neutrophil migration, or positively influencing phagocytosis. Although clinical trials with resolvin in humans after stroke have not been realized, they may soon find application. Aim: The aim of the study was to review the available literature on the scope of the possibilities of the prevention and treatment of stroke with the use of resolvins, EPA and DHA derivatives. Materials and methods: The review features articles published until 31 January 2020. The search for adequate literature was conducted using the keywords: stroke and resolvins. Over 150 articles were found. Studies not written in English, letters to the editor, conference abstracts, and duplicate information were excluded. Results: In several studies using the animal model, the supplementation of resolvin D2 decreased brain damage caused by myocardial infarction, and it reversed the neurological dysfunction of the brain. A decrease in the concentration of proinflammatory cytokines, such as TNF-α, Il-6, and Il-1β, was also observed, as well as a decrease in the scope of brain damage. In the context of stroke in animals, the treatment with resolvin D2 (RvD2) (injection) has a better effect than supplementation with DHA. Conclusions: Resolvins are characterised by strong anti-inflammatory properties. Resolvins improve prognosis and decrease the risk of developing cardiovascular disease, consequently lowering the risk of stroke, and may find application in the treatment of stroke.

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Self-perceived impact of stroke: A longitudinal comparison between one and five years post-stroke

Cited by 26 publications

References 18 publications

Long-term psychosocial outcome following mild traumatic brain injury and minor stroke: a direct longitudinal comparison

Long-term psychosocial outcome following mild traumatic brain injury and minor stroke: a direct longitudinal comparison

Pre-existing Comorbidity Burden and Patient Perceived Stroke Impact

The Role of Resolvins: EPA and DHA Derivatives Can Be Useful in the Prevention and Treatment of Ischemic Stroke

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