scholarly journals Enlarged perivascular spaces are associated with health-related quality of life in patients with acute ischemic stroke

2017 ◽  
Vol 23 (12) ◽  
pp. 973-979 ◽  
Author(s):  
Yan Liang ◽  
Min Deng ◽  
Yang-Kun Chen ◽  
Vincent Mok ◽  
De-Feng Wang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Perivascular Spaces ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

scholarly journals Brain Imaging Signs and Health-Related Quality of Life after Acute Ischemic Stroke: Analysis of ENCHANTED Alteplase Dose Arm

2020 ◽  
Vol 49 (4) ◽  
pp. 427-436 ◽  
Author(s):  
Xiaoying Chen ◽  
Candice Delcourt ◽  
Lingli Sun ◽  
Zien Zhou ◽  
Sohei Yoshimura ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Brain Imaging ◽  
Performance Model ◽  
Health Related Quality ◽  
Quality Of Life Scale ◽  
Related Quality ◽  
Health Related

Background and Purpose: The influence of specific brain lesions on health-related quality of life (HRQoL) after acute ischemic stroke (AIS) is uncertain. We aimed to identify imaging predictors of poor HRQoL in alteplase-treated participants of the alteplase dose arm of the Enhanced Control of Hypertension and Thrombolysis Stroke Study (ENCHANTED). Methods: ENCHANTED was an international trial of low- versus standard-dose intravenous alteplase in AIS patients, with functional outcome (modified Rankin scale [mRS]) and HRQoL on the 5-dimension European Quality of Life Scale (EQ-5D) assessed at 90 days post-randomization. Brain images were analyzed centrally by trained assessors. Multivariable logistic regression was undertaken in the study population randomly divided (2:1) into training (development) and validation (performance) groups, with age (per 10-year increase), ethnicity, baseline National Institutes of Health Stroke Scale (NIHSS) score, diabetes mellitus, premorbid function (mRS score 0 or 1), and proxy respondent, forced into all models. Data are presented with odds ratios (ORs) and 95% confidence intervals (CIs). Results: Eight prediction models were developed and validated in 2,526 AIS patients (median age 67.5 years; 38.4% female; 61.7% Asian) with complete brain imaging and 90-day EQ-5D utility score data. The best performance model included acute ischemic changes in the right (OR 1.69, 95% CI: 1.24–2.29) and deep (OR 1.50, 95% CI: 1.03–2.19) middle cerebral artery (MCA) regions. Several background features of brain frailty – atrophy, white matter change, and old infarcts – were significantly associated with adverse physical but not emotional HRQoL domains. Conclusions: In thrombolysed AIS patients, right-sided and deep ischemia within the MCA territory predict poor overall HRQoL, whilst features of old cerebral ischemia are associated with reduced physical HRQoL.

Abstract T P413: Early Executive Dysfunction Predicts Poor Stroke Outcomes One Year Following Mild Ischemic Stroke

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Hui-Chun Chen ◽  
Alexander W Dromerick ◽  
Chelsea S Kidwell ◽  
Dorothy F Edwards
Keyword(s):  
Quality Of Life ◽  
Life Satisfaction ◽  
Ischemic Stroke ◽  
Activity Participation ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Mild Stroke ◽  
One Year

Background: Cognitive dysfunction has been considered a primary deficit to be addressed after mild stroke. Higher order cognitive deficits immediately after mild stroke may lead to poor longitudinal outcomes. However, existing stroke outcome studies tend to focus on physical capacity and mood rather than cognitive function. Aim: To examine contribution of acute impairment of executive function(EF) and verbal memory (VM) after mild stroke to one year outcomes on Stroke Impact Scale (SIS, health-related quality of life), Activity Card Sort (ACS, activity participation), and Reintegration to Normal Living (RNL, life satisfaction), independent of demographics, ADL and depression. Methods: Patients with ischemic stroke and initial NIHSS ≤ 5 enrolled in PROTECT-DC trial were included. Multiple linear regression analyses identified baseline variables significantly associated with each outcome of interest for all patients completing both baseline and one-year assessments. For each outcome, Model 1 included covariates: age, sex, race, education, lesion side, NIHSS, Barthel Index, Lawton IADL, and depression. In Model 2, all Model 1 variables and dichotomized cognitive variables (impaired versus not impaired) were entered into the equation. Examination of R2 change between Models 1 & 2 identified unique contributions of impaired EF or VM to each one-year outcome beyond Model 1 variables. Results: A total of 86 participants completed baseline assessment and one-year SIS were included for analyses. Our results show that EF was significantly and independently associated with the SIS total score beyond other baseline variables. Participants with acute EF deficits at baseline had poorer SIS outcome at one year: mean 7.47 lower SIS score compared to patients without EF deficits (p = .021). Similar results were found for ACS and RNL. Conclusion: Analyses suggest impact of EF deficits on activity participation, health-related quality of life, and life satisfaction one year after mild stroke. The findings highlight importance of assessment of EF deficits after mild stroke. We suggest that rehabilitation interventions aimed at improving long-term outcomes require careful consideration of assessing and treating EF deficits during the acute phase of mild stroke.

scholarly journals Health-Related Quality of Life Among Patients With Acute Ischemic Stroke and Large Vessel Occlusion in the ESCAPE Trial

Stroke ◽  
2021 ◽  
Author(s):  
Raed A. Joundi ◽  
Alexander D. Rebchuk ◽  
Thalia S. Field ◽  
Eric E. Smith ◽  
Mayank Goyal ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Ischemic Stroke ◽  
Health Related Quality ◽  
Large Vessel Occlusion ◽  
Vessel Occlusion ◽  
Related Quality ◽  
Health Related ◽  
Anxiety Depression ◽  
Free Status

Background and Purpose: Endovascular thrombectomy (EVT) reduces 90-day disability in patients following acute ischemic stroke due to large vessel occlusion. Patient-reported outcome measures after EVT, such as health-related quality of life and specific functional domains, are less well described. Methods: We report outcomes on the EuroQol-5D (EQ-5D) from the ESCAPE (Endovascular Treatment for Small Core and Anterior Circulation Proximal Occlusion With Emphasis on Minimizing CT to Recanalization Times) randomized controlled trial at 90 days after stroke. Death was assigned an index value of 0 for EQ-5D. We used quantile regression to evaluate the association between EVT and EQ-5D index scores and logistic regression for the association between EVT and symptom-free status among 90-day survivors for each EQ-5D dimension (self-care, usual activities, mobility, pain/discomfort, and anxiety/depression), assessing for modification by age or sex and adjusting for baseline factors including stroke severity, affected hemisphere, and receipt of alteplase. Lastly, the association between severe disability at 90 days and EQ-5D was evaluated with assessment for modification by EVT, age, and sex. Results: There were 165 patients randomized to EVT and 150 patients randomized to control. Median EQ-5D was significantly higher for those who received EVT compared with best medical management (0.80 versus 0.60; P <0.001). After accounting for the greater number of deaths in the elderly, there was evidence of modification of treatment effect by age, with older age associated with a larger effect size difference in EQ-5D with EVT. Those receiving EVT had higher odds of symptom-free status in self-care, usual activities, mobility for those aged 60 to 79 years, and pain/discomfort for women, but there was no association with anxiety/depression. Severe disability at 90 days was associated with lower EQ-5D in older compared with younger individuals, and the association was not modified by EVT. Conclusions: Patients treated with EVT report substantially improved health-related quality of life, with relatively greater impact in older individuals and observed benefit across multiple dimensions.

scholarly journals Health-related quality of life measures for a cost-effectiveness analysis of ischemic stroke therapies

Kontakt ◽  
2020 ◽  
Vol 22 (2) ◽  
pp. 128-136 ◽  
Author(s):  
Irena Drugdová ◽  
Vladimír Rogalewicz ◽  
Martin Šrámek ◽  
Veronika Kopalová ◽  
Ondřej Krahula ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Ischemic Stroke ◽  
Cost Effectiveness ◽  
Cost Effectiveness Analysis ◽  
Health Related Quality ◽  
Quality Of Life Measures ◽  
Effectiveness Analysis ◽  
Related Quality ◽  
Health Related

scholarly journals Health-Related Quality of Life Among Young Adults With Ischemic Stroke on Long-Term Follow-Up

Stroke ◽  
2006 ◽  
Vol 37 (5) ◽  
pp. 1232-1236 ◽  
Author(s):  
Halvor Naess ◽  
Ulrike Waje-Andreassen ◽  
Lars Thomassen ◽  
Harald Nyland ◽  
Kjell-Morten Myhr
Keyword(s):  
Quality Of Life ◽  
Young Adults ◽  
Ischemic Stroke ◽  
Health Related Quality ◽  
Related Quality ◽  
Long Term Follow Up ◽  
Health Related
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