Long-term functional outcome and quality of life 2.5 years after thrombolysis in acute ischemic stroke
-
Published:2023-11-09
Issue:1
Volume:5
Page:
-
ISSN:2524-3489
-
Container-title:Neurological Research and Practice
-
language:en
-
Short-container-title:Neurol. Res. Pract.
Author:
Schäbitz Marie, Möller Leona, Friedrich Anja, Klein Nele, Kitsiou Alkisti, Greeve Isabell, Gerstner Anja, Wulff Leonard, Schäbitz Wolf-Rüdiger, Timmermann Lars, Rogalewski AndreasORCID
Abstract
Abstract
Background
Evaluation of outcome after stroke is largely based on assessment of gross function 3 months after stroke onset using scales such as mRS. Cognitive or social functions, level of symptom burden or emotional health are not usually assessed, nor are data available on long-term functional outcomes years after stroke.
Methods
Analysis of 1141 patients with AIS treated with IVT from two major German university hospitals between 2017 and 2020. Patient characteristics and short-term outcome were analysed from patient records. Long-term outcome of 228 patients with prior written informed consent was assessed via telephone survey using mRS and PROMs (EQ-5D-5L, EQ-VAS) 2.5 years after stroke.
Results
Predictors of excellent to good long-term outcome were younger age, event to door time ≤ 2 h, NIHSS ≤ 6 on admission and NIHSS ≤ 6 after IVT. Stroke recurrence was a negative predictor. Predictors of excellent quality of life at 2.5 years included age < 73 years, lower NIHSS after IVT, absence of hypertension. Quality of life was rated in all dimensions with a medium score of 1 and a medium EQ-VAS of 70, representing the good general health status of this stroke population.
Conclusion
Main predictors of an excellent to good long-term outcome and excellent QoL 2.5 years after stroke are younger age, lower NIHSS, and event to door time ≤ 2 h. Research on long-term outcome after disease and treatment is of utmost importance, as it has the ability to reveal the patient true functional outcome and quality of life and to provide information on the status of independence and self-esteem.
Funder
Universität Bielefeld
Publisher
Springer Science and Business Media LLC
Subject
Neurology (clinical),Neurology
Reference30 articles.
1. Bautista, A. E., Meyer, D. M., & Meyer, B. C. (2019). Novel definition of stroke “good responders” predicts 90-day outcome after thrombolysis. Journal of Stroke and Cerebrovascular Diseases. https://doi.org/10.1016/j.jstrokecerebrovasdis.2019.104422 2. Berge, E., Whiteley, W., Audebert, H., De Marchis, G. M., Fonseca, A. C., Padiglioni, C., de la Ossa, N. P., Strbian, D., Tsivgoulis, G., & Turc, G. (2021). European Stroke Organisation (ESO) guidelines on intravenous thrombolysis for acute ischaemic stroke. European Stroke Journal, 6(1), 1–5. https://doi.org/10.1177/2396987321989865 3. Bland, J. M., & Altman, D. G. (1995). Multiple significance tests: The Bonferroni method. BMJ, 310(6973), 170. https://doi.org/10.1136/BMJ.310.6973.170 4. Brooks, R., & De Charro, F. (1996). EuroQol: The current state of play. Health Policy, 37(1), 53–72. https://doi.org/10.1016/0168-8510(96)00822-6 5. Campbell, B. C. V., Ma, H., Ringleb, P. A., Parsons, M. W., Churilov, L., Bendszus, M., Levi, C. R., Hsu, C., Kleinig, T. J., Fatar, M., Leys, D., Molina, C., Wijeratne, T., Curtze, S., Dewey, H. M., Barber, P. A., Butcher, K. S., De Silva, D. A., Bladin, C. F., … Williams, M. (2019). Extending thrombolysis to 4·5-9 h and wake-up stroke using perfusion imaging: A systematic review and meta-analysis of individual patient data. Lancet (London, England), 394(10193), 139–147. https://doi.org/10.1016/S0140-6736(19)31053-0
|
|