Sophie Galanth1, Benoit Tressieres2, Annie Lannuzel3, Patrick Foucan1, Cosmin Alecu4. 1. Physical Medicine and Rehabilitation Department, University Hospital of Pointe-à-Pitre, Guadeloupe, French West Indies. 2. CIC-EC Antilles Guyane CIE 802 Inserm, Guadeloupe, French West Indies. 3. Neurology Department, University Hospital of Pointe-à-Pitre, Guadeloupe, French West Indies; Antilles Guyane University, 97159 Pointe-à-Pitre, Guadeloupe, French West Indies; Sorbonne Pierre and Marie Curie University Paris 06, Inserm, CNRS, UM 75, U1127, ICM, Paris, France. 4. Neurology Department, University Hospital of Pointe-à-Pitre, Guadeloupe, French West Indies; ECM/LAMIA EA4540, Antilles Guyane University, 97159 Pointe-à-Pitre, Guadeloupe, French West Indies. Electronic address: cosmin.alecu@chu-guadeloupe.fr.
Abstract
OBJECTIVE: To evaluate functional outcome and quality of life 1 year poststroke in a Caribbean population. DESIGN: Prospective study of patients with a first hemispheric stroke admitted consecutively between December 2010 and February 2011. The patients were evaluated (1) in the emergency department, (2) when discharged from the hospital, and (3) 1 year poststroke. SETTING: A university hospital. PARTICIPANTS: Of the 140 consecutive patients with stroke, 78 (42% women, 24.4% hemorrhagic stroke) were included in the study. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Patients were evaluated using the National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), FIM, and Medical Outcomes Study 36-Item Short-Form Health Survey. RESULTS: The mean age of the participants was 62.1±17.7 years; 70.5% of patients had hypertension, 29.4% had diabetes, and 23.6% had chronic renal failure. At 1 year poststroke, the mortality rate was 29.4%, and the recurrence rate 2.6%. We evaluated 39 of the 55 survivors (71%). Score evolution (emergency department vs 1y later) is as follows: for the NIHSS, it was 6.2±4.9 versus 3.3±3.9 (z=-3.578; P<.001); and for the mRS score ≤2, it was 54.2% versus 66.7% (χ(2)=14.182; P=.25). The FIM score on discharge from the hospital versus 1 year later was 103.2±28.2 versus 101.7±31.5 (z=-1.008; P=.313). Multivariate analysis showed that aphasia, hemianopia, and incontinence significantly influenced the 1-year FIM score (P<.001). Quality of life, a patient-reported outcome measure of health-related quality of life, was significantly altered concerning vitality, role physical, and role emotional. CONCLUSIONS: One year after a first stroke, despite significant improvement of neurologic impairment, the level of dependency did not change and quality of life was altered. Aphasia, hemianopia, and incontinence significantly influenced functional state.
OBJECTIVE: To evaluate functional outcome and quality of life 1 year poststroke in a Caribbean population. DESIGN: Prospective study of patients with a first hemispheric stroke admitted consecutively between December 2010 and February 2011. The patients were evaluated (1) in the emergency department, (2) when discharged from the hospital, and (3) 1 year poststroke. SETTING: A university hospital. PARTICIPANTS: Of the 140 consecutive patients with stroke, 78 (42% women, 24.4% hemorrhagic stroke) were included in the study. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Patients were evaluated using the National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), FIM, and Medical Outcomes Study 36-Item Short-Form Health Survey. RESULTS: The mean age of the participants was 62.1±17.7 years; 70.5% of patients had hypertension, 29.4% had diabetes, and 23.6% had chronic renal failure. At 1 year poststroke, the mortality rate was 29.4%, and the recurrence rate 2.6%. We evaluated 39 of the 55 survivors (71%). Score evolution (emergency department vs 1y later) is as follows: for the NIHSS, it was 6.2±4.9 versus 3.3±3.9 (z=-3.578; P<.001); and for the mRS score ≤2, it was 54.2% versus 66.7% (χ(2)=14.182; P=.25). The FIM score on discharge from the hospital versus 1 year later was 103.2±28.2 versus 101.7±31.5 (z=-1.008; P=.313). Multivariate analysis showed that aphasia, hemianopia, and incontinence significantly influenced the 1-year FIM score (P<.001). Quality of life, a patient-reported outcome measure of health-related quality of life, was significantly altered concerning vitality, role physical, and role emotional. CONCLUSIONS: One year after a first stroke, despite significant improvement of neurologic impairment, the level of dependency did not change and quality of life was altered. Aphasia, hemianopia, and incontinence significantly influenced functional state.
Authors: J C Radosa; C G Radosa; C Kastl; R Mavrova; L Gabriel; S Gräber; G Wagenpfeil; S Baum; A Hamza; R Joukhadar; I Juhasz-Böss; A-S Heimes; G Meyberg-Solomayer; E-F Solomayer; M P Radosa Journal: Geburtshilfe Frauenheilkd Date: 2016-04 Impact factor: 2.915