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Title: Quality of life after stroke: the North East Melbourne Stroke Incidence Study (NEMESIS)
Authors: Sturm, Jonathan ;Donnan, G.A.;Dewey, H.M.;Macdonell, R.A.;Gilligan, A.K.;Srikanth, V.K.;Thrift, A.G.
Issue Date: Oct-2004
Source: Volume 35, Issue 10, pp. 2340 -2345
Journal title: Stroke
Abstract: BACKGROUND AND PURPOSE: Health-related quality of life (HRQoL) data are scarce from unselected populations. The aims were to assess HRQoL at 2 years poststroke, to identify determinants of HRQoL in stroke survivors, and to identify predictors at stroke onset of subsequent HRQoL. METHODS: All first-ever cases of stroke in a population of 306 631 over a 1-year period were assessed. Stroke severity, comorbidity, and demographic information were recorded. Two-year poststroke HRQoL was assessed using the Assessment of Quality of Life (AQoL) instrument (deceased patients score=0). Handicap, disability, physical impairment, depression, anxiety, living arrangements, and recurrent stroke at 2 years were documented. If necessary, proxy assessments were obtained, except for mood. Linear regression analyses were performed to identify factors independently associated with HRQoL. RESULTS: Of 266 incident cases alive at 2 years, 225 (85%) were assessed. The mean AQoL utility score for all survivors was 0.47 (95% CI, 0.42 to 0.52). Almost 25% of survivors had a score of < or =0.1. The independent determinants of HRQoL in survivors were handicap, physical impairment, anxiety and depression, disability, institutionalization, dementia, and age. The factors present at stroke onset that independently predicted HRQoL at 2 years poststroke were age, female sex, initial NIHSS score, neglect, and low socioeconomic status. CONCLUSIONS: A substantial proportion of stroke survivors have very poor HRQoL. Interventions targeting handicap and mood have the potential to improve HRQoL independently of physical impairment and disability.
DOI: 10.1161/01.STR.0000141977.18520.3b
ISSN: 0039-2499
Publicaton type: Journal Article
Keywords: Neurology
Appears in Collections:Neurology

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