Objectives: Stroke causes severe long-term disabilities with a significant reduction in quality of life (QoL). Our aim was to explore the predictive value of cognitive screening in the acute phase of stroke on QoL after discharge. Materials: 3–10 days after stroke patients underwent the OCS, providing a five domain-specific cognitive profile. The National Institute of Health and Stroke Scale (NIHSS) estimated the stroke severity. QoL was evaluated by the Stroke Impact Scale 3.0 (SIS), a self-reported questionnaire with a 4-factor structure: Physical, cognitive, emotional, and social participation dimensions. Methods: This is a longitudinal study. At baseline, stroke patients (both ischemic and hemorrhagic) were consecutively enrolled. Exclusion criteria: Pre-morbid cognitive decay, difficulties with Italian language, visual impairment or other preexisting conditions affecting cognitive status. OCS was considered not applicable when patients failed the preliminary subtests. At follow-up (FU), patients were invited to participate in an online survey exploring QoL. The correlation between OCS (total score) and QoL was explored by multivariate linear regression analyses. Results: Between October 2019 and September 2021, 124 patients admitted to the Stroke Unit of Poliambulanza Foundation of Brescia underwent OCS. Eighty-two patients completed the online survey on QoL. Mean time of FU (months) was 11.75 (SD 7.52). Characteristics of the final sample: 54 (65.9%) male, mean age (years) 62.29 (SD 13.99), mean initial NIHSS score 2.84 (SD 3.91), 75 patients (91.5%) had an ischemic stroke and 47 (57.3%) a left side brain lesion. At baseline, age (B -.05; 95% CI -.08; -.01, p= .022) and NIHSS score (B -.17; 95% CI -.31; -.03; p= .019) were negatively associated to OCS total performance. At FU, patients showed the following scores on SIS factors (range 0-100, higher score means a better QoL): physical (M 79.55; SD 17.12), cognitive (M 88.08; SD 13.17), emotional (M 75.86; SD 16.98), and social participation (M 84.30; SD 20.14). Baseline OCS was positively associated with physical (B 1.46, 95%CI .03-2.90; p= .045), emotional (B 1.50, 95%CI -.29-3.04; p= .054), and social participation (B 1.71, 95% CI .01- 3.40; p= .048) QoL dimensions, after adjusting for age and NIHSS score. Discussion: At our online survey all dimensions of QoL resulted impacted by stroke. Cognitive screening in the acute phase of stroke was significantly associated to QoL after discharge. Conclusions: OCS in acute stroke setting seems to be an independent predictor of QoL and could help clinicians in the long-term management of patients
Ciccarelli, N., Pini, E., Laini, V., Pepe, F., Magni, E., (Abstract) POST-STROKE QUALITY OF LIFE AND COGNITIVE FUNCTIONING: ALONGITUDINAL STUDY, <<NEUROLOGICAL SCIENCES>>, 2022; 43 (S1): s407-s407. [doi:10.1007/s10072-022-06531-9] [https://hdl.handle.net/10807/223455]
POST-STROKE QUALITY OF LIFE AND COGNITIVE FUNCTIONING: A LONGITUDINAL STUDY
Ciccarelli, Nicoletta
;Magni, Eugenio
2022
Abstract
Objectives: Stroke causes severe long-term disabilities with a significant reduction in quality of life (QoL). Our aim was to explore the predictive value of cognitive screening in the acute phase of stroke on QoL after discharge. Materials: 3–10 days after stroke patients underwent the OCS, providing a five domain-specific cognitive profile. The National Institute of Health and Stroke Scale (NIHSS) estimated the stroke severity. QoL was evaluated by the Stroke Impact Scale 3.0 (SIS), a self-reported questionnaire with a 4-factor structure: Physical, cognitive, emotional, and social participation dimensions. Methods: This is a longitudinal study. At baseline, stroke patients (both ischemic and hemorrhagic) were consecutively enrolled. Exclusion criteria: Pre-morbid cognitive decay, difficulties with Italian language, visual impairment or other preexisting conditions affecting cognitive status. OCS was considered not applicable when patients failed the preliminary subtests. At follow-up (FU), patients were invited to participate in an online survey exploring QoL. The correlation between OCS (total score) and QoL was explored by multivariate linear regression analyses. Results: Between October 2019 and September 2021, 124 patients admitted to the Stroke Unit of Poliambulanza Foundation of Brescia underwent OCS. Eighty-two patients completed the online survey on QoL. Mean time of FU (months) was 11.75 (SD 7.52). Characteristics of the final sample: 54 (65.9%) male, mean age (years) 62.29 (SD 13.99), mean initial NIHSS score 2.84 (SD 3.91), 75 patients (91.5%) had an ischemic stroke and 47 (57.3%) a left side brain lesion. At baseline, age (B -.05; 95% CI -.08; -.01, p= .022) and NIHSS score (B -.17; 95% CI -.31; -.03; p= .019) were negatively associated to OCS total performance. At FU, patients showed the following scores on SIS factors (range 0-100, higher score means a better QoL): physical (M 79.55; SD 17.12), cognitive (M 88.08; SD 13.17), emotional (M 75.86; SD 16.98), and social participation (M 84.30; SD 20.14). Baseline OCS was positively associated with physical (B 1.46, 95%CI .03-2.90; p= .045), emotional (B 1.50, 95%CI -.29-3.04; p= .054), and social participation (B 1.71, 95% CI .01- 3.40; p= .048) QoL dimensions, after adjusting for age and NIHSS score. Discussion: At our online survey all dimensions of QoL resulted impacted by stroke. Cognitive screening in the acute phase of stroke was significantly associated to QoL after discharge. Conclusions: OCS in acute stroke setting seems to be an independent predictor of QoL and could help clinicians in the long-term management of patients
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