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Can acute clinical outcomes predict health-related quality of life after stroke: a one-year prospective study of stroke survivors.
Abstract
<h4>Background</h4>Health-related quality of life (HRQoL) is a key metric to understand
the impact of stroke from patients' perspective. Yet HRQoL is not readily measured
in clinical practice. This study aims to investigate the extent to which clinical
outcomes during admission predict HRQoL at 3 months and 1 year post-stroke.<h4>Methods</h4>Stroke
patients admitted to five tertiary hospitals in Singapore were assessed with Shah-modified
Barthel Index (Shah-mBI), National Institute of Health Stroke Scale (NIHSS), Modified
Rankin Scale (mRS), Mini-Mental State Examination (MMSE), and Frontal Assessment Battery
(FAB) before discharge, and the EQ-5D questionnaire at 3 months and 12 months post-stroke.
Association of clinical measures with the EQ index at both time points was examined
using multiple linear regression models. Forward stepwise selection was applied and
consistently significant clinical measures were analyzed for their association with
individual dimensions of EQ-5D in multiple logistic regressions.<h4>Results</h4>All
five clinical measures at baseline were significant predictors of the EQ index at
3 months and 12 months, except that MMSE was not significantly associated with the
EQ index at 12 months. NIHSS (3-month standardized β = - 0.111; 12-month standardized
β = - 0.109) and mRS (3-month standardized β = - 0.122; 12-month standardized β = - 0.080)
were shown to have a larger effect size than other measures. The contribution of NIHSS
and mRS as significant predictors of HRQoL was mostly explained by their association
with the mobility, self-care, and usual activities dimensions of EQ-5D.<h4>Conclusions</h4>HRQoL
at 3 months and 12 months post-stroke can be predicted by clinical outcomes in the
acute phase. NIHSS and mRS are better predictors than BI, MMSE, and FAB.
Type
Journal articleSubject
HumansLinear Models
Prospective Studies
Quality of Life
Aged
Middle Aged
Survivors
Female
Male
Stroke
Surveys and Questionnaires
Outcome Assessment, Health Care
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https://hdl.handle.net/10161/22793Published Version (Please cite this version)
10.1186/s12955-018-1043-3Publication Info
Yeoh, Yen Shing; Koh, Gerald Choon-Huat; Tan, Chuen Seng; Lee, Kim En; Tu, Tian Ming;
Singh, Rajinder; ... Luo, Nan (2018). Can acute clinical outcomes predict health-related quality of life after stroke: a
one-year prospective study of stroke survivors. Health and quality of life outcomes, 16(1). pp. 221. 10.1186/s12955-018-1043-3. Retrieved from https://hdl.handle.net/10161/22793.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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Show full item recordScholars@Duke
Helen Marie Hoenig
Professor of Medicine
1. General Focus and Goals of Research: Dr. Hoenig's research focuses on rehabilitation,
and more specifically on assistive technology and teletechnology. Patient populations
of interest include geriatric patients with diverse medical problems including stroke,
spinal and/or musculoskeletal disorders. 2. Specific Approaches or Techniques: Randomized
controlled trials, epidemiological studies including large data base analyses and
survey research. Clinical trials include studies of t
David Bruce Matchar
Professor of Medicine
My research relates to clinical practice improvement - from the development of clinical
policies to their implementation in real world clinical settings. Most recently my
major content focus has been cerebrovascular disease. Other major clinical areas in
which I work include the range of disabling neurological conditions, cardiovascular
disease, and cancer prevention. Notable features of my work are: (1) reliance on
analytic strategies such as meta-analysis, simulation, decision analy
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