期刊
STROKE
卷 48, 期 7, 页码 1925-+出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1161/STROKEAHA.117.017094
关键词
cognition; lower extremity; magnetic resonance imaging; patient outcome assessment; quality of life; stroke
资金
- National Heart, Lung, and Blood Institute [5F31HL117618]
- Agency for Healthcare Research and Quality [K18 HS023437]
- National Institute of Neurological Diseases and Stroke [5R01NS093908-03]
Background and Purpose-Limited data exist on the relationship between acute infarct volume and health-related quality of life (HRQOL) measures after ischemic stroke. We evaluated whether acute infarct volume predicts domain-specific Neuro-Quality of Life scores at 3 months after stroke. Methods-Between 2012 and 2014, we prospectively enrolled consecutive patients with ischemic stroke and calculated infarct volume. Outcome scores at 3 months included modified Rankin Scale and Neuro-Quality of Life T scores. We evaluated whether volume organized by quartiles predicted modified Rankin Scale and HRQOL scores at 3 months using logistic and linear regression as appropriate, adjusting for relevant covariates. We calculated variance accounted for (R-2) overall and by volume for each domain of HRQOL. Results-Among 490 patients (mean age 64.2 +/- 15.86 years; 51.2% male; 63.3% White) included for analysis, 58 (11.8%) were disabled (modified Rankin Scale score of >2) at 3 months. In unadjusted analysis, the highest volume quartile remained a significant predictor of 1 HRQOL domain, applied cognition-general concerns (R-2=0.06; P<0.001). Our fully adjusted prediction model explained 32% to 51% of the variance in HRQOL: upper extremity (R-2=0.32), lower extremity (R-2=0.51), executive function (R-2=0.45), and general concerns (R-2=0.34). Conclusions-Acute infarct volume is a poor predictor of HRQOL domains after ischemic stroke, with the exception of the cognitive domain. Overall, clinical and imaging variables explained <50% of the variance in HRQOL outcomes at 3 months. Our data imply that a broad range of factors, some known and others undiscovered, may better predict poststroke HRQOL than what is currently available.
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