Factors Affecting the Quality of Life in Patients with Stroke

Objectives

To study the factors that can independently predict healthrelated quality of life (HRQOL) 1 year after stroke.

Methods

A total no of 58 patients over a period of 2 yrs with first ever history of stroke were assessed for initial stroke severity within 48 hrs of the onset & HRQOL using the Short Form 36 (SF36) 1 year after stroke. Physical (PHSS) and mental health (MHSS) summary scores were derived from the eight domains of HRQOL in the SF36. To determine independent predictors of these scores multivariate stepwise regression analyses were conducted; ß coefficients with 95% CI were obtained. Demographic and stroke risk factors, initial stroke severity neurological impairments and cognitive impairment (MMSE <24) were included in the models. Similar analyses were undertaken on 150 subjects 3 years post-stroke.

Results

A year after stroke, independent predictors of the worst PHSS were of females (ß coefficient -3.3: 95% CI -5.7 to - 5.8),diabetes (-4.2: -7.7 to -0.8), right hemispheric lesions (-4.9: -8.7 to -1.2), initial stroke severity (-7.8: -11.6 to - 4.1) and cognitive impairment (-2.7: -5.5 to -0.1); the worst MHSS were associated with being ischaemic heart disease (-2.7: -5.4 to -0.03), cognitive impairment (-3.04: -5.8 to - 0.3). Subjects aged 60-70 years (5.4: 2.5 to -8.4) had better MHSS than those <60 years.

Conclusions

Factors affecting HRQOL vary whether physical or psychosocial aspects of HRQOL are being considered. This study provides valuable information on factors predicting HRQOL, which can be taken into consideration in audits of clinical practice or in future interventional studies aiming to improve HRQOL after stroke.