Determinants of Quality of Life in Stroke Survivors After 6 Months, from a Comprehensive Stroke Unit: A Longitudinal Study.

ABSTRACT

BACKGROUND: In the social model of stroke, health-related quality of life (HRQoL) is the result of interplay among stroke severity, social support, and health-promoting behaviors. Our objective was to identify determinants of HRQoL in stroke survivors. METHODS: Ischemic stroke patients were evaluated at 6 months with the Short Form 12 Health Survey, including physical component survey (PCS) and mental health component survey (MCS) summary scores. Multivariate stepwise regression analyses determined independent predictors of scores. Models included age, gender, socioeconomic class, education, residential environment, social support, previous comorbidity (Charlson Index), previous stroke, side of stroke, National Institutes of Health Stroke Scale (NIHSS) score at admission, Barthel Index (BI) and modified Rankin Scale (mRS) scores at discharge, and length of stay. RESULTS: A total of 131 patients participated (mean age 70.1, SD = 12.5; 62.6% males). In all, 33.6% had a BI score <90 and an mRS score >2 (poor outcome). The mean (SD) PCS score was 39.46 (9.3) and mean (SD) MCS score was 34.86 (10.1). Lower PCS score was associated with female sex (ß = 0.204, p = .009), poor social support (ß = -0.225, p = .003), and poor Charlson Index (ß = -0.162, p = .032) and BI scores (ß = 0.384, p < .0001). Lower MCS score was associated with female sex (ß = 0.162, p = .062) and poor NIHSS (ß = -0.265, p = .019) and BI scores (ß = 0.203, p < .071). CONCLUSION: Stroke severity, disability, gender, social support, and previous stroke have significant impacts on the physical and mental domains of generic HRQoL.