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Abstract
Objectives To compare the degrees to which 8 domains of health are affected across types of cerebrovascular events and to identify factors associated with domain scores in different event types.
Methods This was an observational cohort study of 2,181 patients with ischemic stroke, intracerebral hemorrhage (ICH), subarachnoid hemorrhage (SAH), or TIA in a cerebrovascular clinic from February 17, 2015, to June 2, 2017 who completed Quality of Life in Neurologic Disorders executive function and the following Patient-Reported Outcomes Measurement Information System scales as part of routine care: physical function, satisfaction with social roles, fatigue, anxiety, depression, pain interference, and sleep disturbance.
Results All health domains were affected to similar degrees in patients with ICH, SAH, and ischemic stroke after adjustment for disability and other clinical factors, whereas patients with TIA had worse adjusted scores for 5 of the 8 domains of health. Female sex, younger age, lower income, and event <90 days were associated with worse scores in multiple domains. Factors associated with health domain scores were similar for all cerebrovascular events. Most affected domains for all were physical function, satisfaction with social roles, and executive function.
Conclusions The subtype of stroke (ischemic stroke, ICH, and SAH) had similar effects in multiple health domains, while patients with TIA had worse adjusted outcomes, suggesting that the mechanisms for outcomes after TIA may differ from those of other cerebrovascular events. The most affected domains across all event types were physical function, satisfaction with social roles, and executive function, highlighting the need to develop effective interventions to improve these health domains in survivors of these cerebrovascular events.
Glossary
- CAT=
- computer adaptive testing;
- ICD-CM=
- International Classification of Diseases, Clinical Modification;
- ICH=
- intracerebral hemorrhage;
- mRS=
- modified Rankin Scale;
- NeuroQoL=
- Quality of Life in Neurologic Disorders;
- NIHSS=
- NIH Stroke Scale;
- PROM=
- patient-reported outcome measure;
- PROMIS=
- Patient Reported Outcome Measurement Information System;
- SAH=
- subarachnoid hemorrhage;
- TNA=
- transient neurologic attack
Footnotes
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
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- Received May 14, 2018.
- Accepted in final form August 21, 2018.
- © 2018 American Academy of Neurology
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Disputes & Debates: Rapid online correspondence
- Author response to Dr. Spector
- Symptoms reported after an event are not necessarily outcomes of the event
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