The association of stroke severity with health-related quality of life in survivors of acute cerebrovascular disease and
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The association of stroke severity with health‑related quality of life in survivors of acute cerebrovascular disease and their informal caregivers during the first year post stroke: a survey study Angela S. Labberton1 · Liv Ariane Augestad2 · Bente Thommessen3 · Mathias Barra1 Accepted: 24 April 2020 © The Author(s) 2020
Abstract Purpose To describe the health-related quality of life (HRQoL) of caregivers and survivors of transient ischaemic attack (TIA) and stroke during one year post discharge in comparison to age- and sex-matched population norms; and to analyse the association of initial stroke severity, measured by a routinely used stroke-specific scale, on subsequent HRQoL of caregivers and survivors. Methods Cohort of hospitalized patients with TIA and stroke discharged alive from a large university hospital in Norway, and their informal caregivers. Questionnaires at 3 and 12 months post discharge were filled out by caregivers (n = 320 and n = 326, respectively) and survivors (n = 368 and n = 383, respectively). Multivariable linear regression analyses tested associations between initial stroke severity (National Institutes of Health Stroke Scale, NIHSS) and HRQoL (EQ-5D-3L) in caregivers and survivors. Results Caregivers of survivors with TIA or stroke did not report lower HRQoL than matched norms. There was some evidence of an association of the NIHSS with caregiver HRQoL at 3 months only (age–sex-adjusted coefficient − 0.01, p = 0.008), however, this was attenuated after additional adjustments. Survivors with stroke, but not TIA, reported lower HRQoL than population norms at both time points. There was a negative association between higher NIHSS scores and survivors’ HRQoL; fully adjusted coefficient − 0.01 at both time points (p = 0.001). Conclusion The informal caregivers and survivors with TIA did not report lower than expected HRQoL. Increasing stroke severity was associated with decreasing HRQoL among survivors, but had limited predictive value among caregivers. Other factors may therefore be better indicators of ‘at risk’ caregivers. Keywords Informal caregivers · Cerebrovascular disease · Stroke · Transient ischaemic attack · Quality of life
Introduction
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11136-020-02516-3) contains supplementary material, which is available to authorized users. * Angela S. Labberton [email protected] 1
Health Services Research Unit, Akershus University Hospital, PO Box 1000, 1478 Lørenskog, Norway
2
Department of Health Management and Health Economics, Medical Faculty, University of Oslo, Oslo, Norway
3
Department of Neurology, Akershus University Hospital, Lørenskog, Norway
Stroke is one of the leading causes of death and disability worldwide [1]. The survivors of stroke often have complex persisting impairments requiring long-term care. With increased focus on earlier discharge and re-integration of patients into the community, the role of family and other informal caregivers
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