Quality of life after a first ischemic stroke - Long-term developments and correlations with changes in neurological deficit, mood and cognitive impairment
Quality of life after a first ischemic stroke - Long-term developments and correlations with changes in neurological deficit, mood and cognitive impairment
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DOI：
10.1111/j.1600-0404.1998.tb07289.x
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发表时间：
1998-09-01
影响因子：
3.5
通讯作者：
Vrijens, NLH
中科院分区：
文献类型：
--
作者：
Jonkman, EJ;de Weerd, AW;Vrijens, NLH
背景-关于卒中后生活质量（QOL）决定因素的研究集中在一个方面（最重要的是：神经功能缺损、情绪障碍或认知功能障碍），因此没有提供每个因素对QOL的相对贡献的见解。研究的患者群体通常包含不同类型的中风患者。患者的这种不均匀性导致了对卒中后生活质量的进一步混淆。目的-在一项研究中评估在首次单侧大脑中动脉缺血性卒中后3-12个月内对生活质量重要的因素。设计-在卒中后3个月、6个月和12个月对QOL（疾病影响概况，SIP）、认知状态（韦氏成人智力量表修订版）、情绪和神经功能缺损进行评分。背景-连续的患者在荷兰海牙的综合医院和康复诊所住院。患者-对35例患者进行了3次全面检查。结果进行了比较，20对照组匹配的年龄，最后的职业和教育水平。结果-中风后3至12个月内，神经系统没有显着改善。与估计的发病前水平和对照组相比，认知功能受损。在研究期间未完全恢复。这些患者作为一个整体都很抑郁，并且在研究期间一直如此。3个月时生活质量评分异常，仅略有改善。逐步回归分析显示，抑郁和轻瘫程度是影响SIP总结局的最重要变量。结论：在一组同质性卒中患者中，卒中后3至12个月内生活质量有所改善，但1年后仍高度异常。生活质量的下降与抑郁症相关，在一定程度上与神经功能缺损相关，但与认知障碍无关。
Background - Studies on determinants of quality of life (QOL) after a stroke focus on one aspect (most important: neurological deficit, mood disorders or cognitive failure) and as such provide no insight in the relative contribution of each factor on QOL. The groups of patients studied often contain victims of different types of stroke. This inhomogenity in patients leads to further confusion about QOL after stroke. Objective - To evaluate in one study factors important for QOL in the period 3-12 months after a first one-sided ischemic stroke in the region of the middle cerebral artery. Design - Measures for QOL (Sickness Impact Profile, SIP), cognitive status (Wechsler Adult Intelligence Scale revised), mood and neurological deficit were scored 3, 6 and 12 months after the stroke. Setting - Successive patients admitted to a general hospital and rehabilitation clinic in The Hague, The Netherlands. Patients - A complete examination was performed three times in 35 patients. The results were compared to those of 20 controls matched for age, last occupation and educational level. Results - There was no significant neurological improvement between 3 and 12 months after the stroke. Cognition was impaired when compared to the estimated premorbid level and to the controls. There was incomplete recovery over the study interval. The patients as a group were depressed and remained so over the period of the study. The resulting quality of life scores were abnormal at 3 months and improved only slightly. Stepwise regression analysis revealed that depression and degree of paresis were the most important variables for the SIPtotal outcome. Conclusions - In a homogenous group of stroke patients the QOL improved somewhat in the period 3 to 12 months after the stroke but was still highly abnormal after 1 year. The decrease in QOL was correlated with depression and - to some degree - with neurological deficit, but not to cognitive disturbances.