Irene L Katzan1, Nicolas R Thompson2, Ken Uchino2, Brittany Lapin2. 1. From the Neurological Institute Center for Outcomes Research & Evaluation (I.L.K., N.R.T., B.L.), and Cerebrovascular Center (I.L.K., K.U.), Cleveland Clinic, OH. Katzani@ccf.org. 2. From the Neurological Institute Center for Outcomes Research & Evaluation (I.L.K., N.R.T., B.L.), and Cerebrovascular Center (I.L.K., K.U.), Cleveland Clinic, OH.
Abstract
OBJECTIVES: (1) Examine 8 patient-reported domains of health across levels of disability compared to the US general population; and (2) identify factors associated with domain scores in patients with ischemic stroke. METHODS: Observational cohort study of 1,195 patients in a cerebrovascular clinic from February 17, 2015, to January 27, 2017, who completed Neuro-QoL (Quality of Life in Neurological Disorders) executive function or the following PROMIS (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: Mean age was 62 (±15) years, and 81% were white. Median modified Rankin Scale (mRS) score at the clinic visit was 1 (interquartile range 0-2). Percentage of patients with scores meaningfully worse than the general population ranged from 28% (sleep disturbance) to 63% (physical function). Scores were worse in patients with higher mRS levels, although correlation between scores and mRS level varied (sleep disturbance r = 0.16 to physical function r = 0.52). Most affected domains were physical function (T score = 58.8), satisfaction with social roles (T score = 55.4), and executive function (T score = 53.4). Disability, lower income, and female sex were associated with worse scores in multiple domains. Age was associated with worse physical function but lower anxiety, depression, and sleep disturbance. CONCLUSIONS: Patients with ischemic stroke reported symptoms in multiple domains that increase to variable degrees at higher levels of disability. Physical function, satisfaction with social roles, and executive function were most affected. This information improves our understanding of the well-being of patients with ischemic stroke and brings attention to the importance of social roles and executive function for stroke survivors.
OBJECTIVES: (1) Examine 8 patient-reported domains of health across levels of disability compared to the US general population; and (2) identify factors associated with domain scores in patients with ischemic stroke. METHODS: Observational cohort study of 1,195 patients in a cerebrovascular clinic from February 17, 2015, to January 27, 2017, who completed Neuro-QoL (Quality of Life in Neurological Disorders) executive function or the following PROMIS (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: Mean age was 62 (±15) years, and 81% were white. Median modified Rankin Scale (mRS) score at the clinic visit was 1 (interquartile range 0-2). Percentage of patients with scores meaningfully worse than the general population ranged from 28% (sleep disturbance) to 63% (physical function). Scores were worse in patients with higher mRS levels, although correlation between scores and mRS level varied (sleep disturbance r = 0.16 to physical function r = 0.52). Most affected domains were physical function (T score = 58.8), satisfaction with social roles (T score = 55.4), and executive function (T score = 53.4). Disability, lower income, and female sex were associated with worse scores in multiple domains. Age was associated with worse physical function but lower anxiety, depression, and sleep disturbance. CONCLUSIONS:Patients with ischemic stroke reported symptoms in multiple domains that increase to variable degrees at higher levels of disability. Physical function, satisfaction with social roles, and executive function were most affected. This information improves our understanding of the well-being of patients with ischemic stroke and brings attention to the importance of social roles and executive function for stroke survivors.
Authors: Kathryn M Rexrode; Tracy E Madsen; Amy Y X Yu; Cheryl Carcel; Judith H Lichtman; Eliza C Miller Journal: Circ Res Date: 2022-02-17 Impact factor: 17.367
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Authors: Laura C Polding; William J Tate; Michael Mlynash; Michael P Marks; Jeremy J Heit; Soren Christensen; Stephanie Kemp; Gregory W Albers; Maarten G Lansberg Journal: Stroke Date: 2021-02-18 Impact factor: 7.914
Authors: Brittany R Lapin; Nicolas R Thompson; Andrew Schuster; Ryan Honomichl; Irene L Katzan Journal: Qual Life Res Date: 2021-01-28 Impact factor: 4.147
Authors: Pamela W Duncan; Rica M Abbott; Scott Rushing; Anna M Johnson; Christina N Condon; Sarah L Lycan; Barbara J Lutz; Doyle M Cummings; Amy M Pastva; Ralph B D'Agostino; Jeanette M Stafford; Robert M Amoroso; Sara B Jones; Matthew A Psioda; Sabina B Gesell; Wayne D Rosamond; Janet Prvu-Bettger; Mysha E Sissine; Mark D Boynton; Cheryl D Bushnell Journal: Circ Cardiovasc Qual Outcomes Date: 2018-08
Authors: Irene L Katzan; Andrew Schuster; Lynn Daboul; Christine Doherty; Sidra Speaker; Ken Uchino; Brittany Lapin Journal: JAMA Netw Open Date: 2021-07-01