Is health-related quality of life between 90 and 180 days following stroke associated with long-term unmet needs?
Is health-related quality of life between 90 and 180 days following stroke associated with long-term unmet needs?
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DOI：
10.1007/s11136-016-1234-5
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发表时间：
2016-08-01
影响因子：
3.5
通讯作者：
Cadilhac, D. A.
中科院分区：
文献类型：
--
作者：
Andrew, N. E.;Kilkenny, M. F.;Cadilhac, D. A.
了解健康相关生活质量 (HRQoL) 与长期未满足需求之间的关系对于指导优化中风后生活的服务非常重要。我们调查了中风后 90 至 180 天之间的 HRQoL 是否与长期未满足的需求相关。使用了参加澳大利亚中风幸存者需求调查的澳大利亚中风临床登记处 (AuSCR) 注册者的数据。结果数据（包括 EQ-5D）通常在中风后 90 至 180 天之间在 AuSCR 中收集。未满足的需求以中位数 2 年进行评估，并分类为： 健康；日常生活；工作/休闲；和支持域。使用多变量回归来确定 EQ-5D 维度与经历未满足需求的可能性、视觉模拟量表 (VAS)（评分 0-100）和报告的未满足需求数量之间的关联。 总共有 173 名 AuSCR 注册者完成了需求调查（中位年龄 69 岁，67% 为男性；77% 为缺血性中风）。 VAS 评分与报告的长期未满足需求的数量呈负相关 [irr 0.98, (95 % CI 0.97, 0 99) p < 0.001]。 EQ-5D 活动受限与未满足的生活需求相关（aOR 4.5，95% CI 1.1，18.8）。 90-180 天需要生活支持与未满足的健康需求相关（aOR 4.9，95% CI 1.5，16.1）。 90-180 天出现疼痛的患者不太可能报告未满足的健康状况（aOR 0.09，95 % CI 0.02，0.4）和支持需求（aOR 0.2，95 % CI 0.06，0.6）。定期收集的 HRQoL 数据可以识别有长期未满足需求风险的幸存者。这些信息对于有针对性地提供服务以优化中风后的结果非常重要。
Understanding the relationship between health-related quality of life (HRQoL) and long-term unmet needs is important for guiding services to optimise life following stroke. We investigated whether HRQoL between 90 and 180 days following stroke was associated with long-term unmet needs.Data from Australian Stroke Clinical Registry (AuSCR) registrants who participated in the Australian Stroke Survivor Needs Survey were used. Outcome data, including the EQ-5D, are routinely collected in AuSCR between 90 and 180 days post-stroke. Unmet needs were assessed at a median of 2 years and categorised into: health; everyday living; work/leisure; and support domains. Multivariable regression was used to determine associations between the EQ-5D dimensions and the likelihood of experiencing unmet needs and the visual analogue scale (VAS) (rating 0-100) and number of reported unmet needs.In total, 173 AuSCR registrants completed the Needs Survey (median age 69 years, 67 % male; 77 % ischaemic stroke). VAS scores were negatively associated with the number of reported long-term unmet needs [irr 0.98, (95 % CI 0.97, 0 99) p < 0.001]. Having EQ-5D activity limitations was associated with unmet living needs (aOR 4.5, 95 % CI 1.1, 18.8). Requiring living supports at 90-180 days was associated with unmet health needs (aOR 4.9, 95 % CI 1.5, 16.1). Those with pain at 90-180 days were less likely to report unmet health (aOR 0.09, 95 % CI 0.02, 0.4) and support needs (aOR 0.2, 95 % CI 0.06, 0.6).Routinely collected HRQoL data can identify survivors at risk of experiencing long-term unmet needs. This information is important for targeting service delivery to optimise outcomes following stroke.