Predictors of quality of life 1 year after minor stroke or TIA: a prospective single-centre cohort study

Ka-Hoo Lam, Emma Blom, Vincent I H Kwa, Ka-Hoo Lam, Emma Blom, Vincent I H Kwa

Abstract

Objectives: In patients after a transient ischaemic attack (TIA) or minor stroke, dysfunction is often underestimated by clinical measures due to invisible symptoms, including cognitive and emotional problems. Many of these patients need stroke care programme, but others do not. In this study, we aim to identify potential predictors of quality of life (QoL) in patients with TIA or minor stroke 1 year poststroke to be able to select which of these patients will need aftercare.

Design: Prospective observational cohort study.

Setting: Single-centre hospital in the Netherlands.

Participants: 120 patients, diagnosed with TIA or minor stroke and discharged without rehabilitation treatment, completed the study.

Primary and secondary outcome measures: QoL (RAND-36), anxiety and depressive symptoms (Hospital Anxiety and Depression scale), the degree of disability or functional dependence after stroke (modified Rankin Scale (mRS)) and symptoms of anxiety and depression specific to stroke (SSADQ) were assessed at baseline (2-6 weeks poststroke) and compared with follow-up at 1 year poststroke.

Results: Depression (B=-1.35, p<0.001) and anxiety (B=-0.57, p=0.041) at baseline predicted a worse mental component of QoL after 1 year. Depression (B=-1.100, p<0.001) at baseline, but also age (B=-0.261, p=0.002) and female sex (B=4.101, p=0.034) predicted a worse physical component of QoL after 1 year.

Conclusion: With the identification of these predictors, we might be able to select more efficiently and timely the patients with TIA or minor stroke who need stroke aftercare.

Keywords: follow-up; minor stroke; patient-reported outcomes; prediction; quality of life; transient ischaemic attack.

Conflict of interest statement

Competing interests: None declared.

© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Figures

Figure 1
Figure 1
Flowchart of the study.
Figure 2
Figure 2
Bar graph of RAND-36 subscale scores at baseline and follow-up. BP, bodily pain; FA, fatigue; GH, general health; HC, health change; MH, mental health; PF, physical functioning; RE, role limitations due to mental problems; RP, role limitations due to physical problems; SF, social functioning; VT, vitality. *Statistically significant difference.

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