Variations in Health-Related Quality of Life (HRQoL) and Survival 1 Year After Stroke: Five European Population-based Registers

Overview

Journal BMJ Open

Specialty General Medicine

Date 2015 Jun 4

PMID 26038354

Citations 17

Authors

Salma Ayis

Ian Wellwood

Anthony G Rudd

Christopher McKevitt

David Parkin

Charles D A Wolfe

Affiliations

Soon will be listed here.

Abstract

Objective: There were two main objectives: to describe and compare clinical outcomes and Patient-Reported Outcome Measures (PROMs) collected using standardised procedures across the European Registers of Stroke (EROS) at 3 and 12 months after stroke; and to examine the relationship between patients' Health-Related Quality of Life (HRQoL) at 3 months after stroke and survival up to 1 year across the 5 populations.

Design: Analysis of data from population-based stroke registers.

Setting: European populations in Dijon (France); Kaunas (Lithuania); London (UK); Warsaw (Poland) and Sesto Fiorentino (Italy).

Participants: Patients with ischaemic or intracerebral haemorrhage (ICH) stroke, registered between 2004 and 2006.

Outcome Measures: (1) HRQoL, assessed by the physical component summary (PCS) and mental component summary (MCS) of the Short-Form Health Survey (SF-12), mapped into the EQ-5D to estimate responses on 5 dimensions (mobility, activity, pain, anxiety and depression, and self-care) and utility scores. (2) Mortality within 3 months and within 1 year of stroke.

Results: Of 1848 patients, 325 were lost to follow-up and 500 died within a year of stroke. Significant differences in mortality, HRQoL and utility scores were found, and remained after adjustments. Kaunas had an increased risk of death; OR 2.34, 95% CI (1.32 to 4.14) at 3 months after stroke in Kaunas, compared with London. Sesto Fiorentino had the highest adjusted PCS: 43.54 (SD=0.96), and Dijon had the lowest adjusted

Mcs: 38.67 (SD=0.67). There are strong associations between levels of the EQ-5D at 3 months and survival within the year. The trend across levels suggests a dose-response relationship.

Conclusions: The study demonstrated significant variations in survival, HRQoL and utilities across populations that could not be explained by stroke severity and sociodemographic factors. Strong associations between HRQoL at 3 months and survival to 1 year after stroke were identified.

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