Comparison of Factors Affecting Quality of Life in Patients with Acute Ischemic Stroke Across Different Stroke Severities
Abstract Introduction Research investigating the differences in determinants affecting the quality of life (QoL) in patients with acute ischemic stroke (AIS) of varying severities remains limited, and how these factors influence QoL remains unclear. The aim of this study was to address this critical...
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Adis, Springer Healthcare
2025-04-01
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| Series: | Neurology and Therapy |
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| Online Access: | https://doi.org/10.1007/s40120-025-00743-9 |
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| author | Yuxuan Lu Weiping Sun Yining Huang Zhaoxia Wang Zhiyuan Shen Wei Sun Ran Liu Fan Li Junlong Shu Qing Peng Jingjing Jia Peng Sun Yijun Song Haiqiang Jin CASTOR Investigators |
| author_facet | Yuxuan Lu Weiping Sun Yining Huang Zhaoxia Wang Zhiyuan Shen Wei Sun Ran Liu Fan Li Junlong Shu Qing Peng Jingjing Jia Peng Sun Yijun Song Haiqiang Jin CASTOR Investigators |
| author_sort | Yuxuan Lu |
| collection | DOAJ |
| description | Abstract Introduction Research investigating the differences in determinants affecting the quality of life (QoL) in patients with acute ischemic stroke (AIS) of varying severities remains limited, and how these factors influence QoL remains unclear. The aim of this study was to address this critical issue, refining treatments to enhance long-term QoL and optimize resource use. Methods In this multicenter prospective study conducted in China, patients with AIS were assessed using the EuroQol-5 Dimension (EQ-5D) questionnaire at admission and 1 year later. Univariate and multivariate analyses were conducted to identify QoL determinants. Motor function-related outcomes (MFRO) and non-motor function-related outcomes (NMFRO) were defined based on the EQ-5D questionnaire to explore how factors influence outcomes through mediation analysis. Results The study included 8598 patients with AIS (median age 64 years; 65.7% male), 3927 of whom had minor stroke severity (National Institutes of Health Stroke Scale [NIHSS] scores ≤ 3). The median QoL score improved from 0.597 at admission to 1.000 after 1 year. Compared to patients with minor stroke, more patients with non-minor stroke had non-motor function-related problems (NMFRP) at admission (78.2% vs. 56.6%). Age, stroke history, QoL at admission, infection, hospitalization costs, and discharge outcomes were found to be factors influencing QoL in both cohorts. In the non-minor stroke cohort, analysis revealed that additional factors include diabetes mellitus, geographical region, speech impairment, and thrombolysis, while in the minor stroke cohort, hypertension, coronary heart disease, cancer, prolonged length of stay, and hemorrhage were found to be relevant factors. The impact of most factors on QoL was mediated by MFRO, while the effects of age, speech impairment, and geographical region were also mediated by NMFRO. Hospitalization costs beyond 15,000 China Yuan (CNY) did not improve QoL for the patients with non-minor stroke, with a threshold of 10,000 CNY for the patients with minor stroke. Conclusions Over half of the patients in the study population had NMFRP, necessitating greater medical attention. Patients with different stroke severities had distinct QoL determinants. Age, speech impairment, and geographical region may exert an impact partly mediated through NMFRO. Higher hospitalization costs did not consistently improve QoL beyond a certain threshold. Trial Registration ClinicalTrials.gov Identifier: NCT02470624. |
| format | Article |
| id | doaj-art-834a375cf1e644939b1f96abb7f254ed |
| institution | DOAJ |
| issn | 2193-8253 2193-6536 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Adis, Springer Healthcare |
| record_format | Article |
| series | Neurology and Therapy |
| spelling | doaj-art-834a375cf1e644939b1f96abb7f254ed2025-08-20T03:08:28ZengAdis, Springer HealthcareNeurology and Therapy2193-82532193-65362025-04-011431023103810.1007/s40120-025-00743-9Comparison of Factors Affecting Quality of Life in Patients with Acute Ischemic Stroke Across Different Stroke SeveritiesYuxuan Lu0Weiping Sun1Yining Huang2Zhaoxia Wang3Zhiyuan Shen4Wei Sun5Ran Liu6Fan Li7Junlong Shu8Qing Peng9Jingjing Jia10Peng Sun11Yijun Song12Haiqiang Jin13CASTOR InvestigatorsDepartment of Neurology, Peking University First HospitalDepartment of Neurology, Peking University First HospitalDepartment of Neurology, Peking University First HospitalDepartment of Neurology, Peking University First HospitalDepartment of Neurology, The First Hospital of Hebei Medical UniversityDepartment of Neurology, Peking University First HospitalDepartment of Neurology, Peking University First HospitalDepartment of Neurology, Peking University First HospitalDepartment of Neurology, Peking University First HospitalDepartment of Neurology, Peking University First HospitalDepartment of Neurology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s HealthDepartment of Neurology, Peking University First HospitalDepartment of Internal Neurology, Yantai Penglai Traditional Chinese Medicine HospitalDepartment of Neurology, Peking University First HospitalAbstract Introduction Research investigating the differences in determinants affecting the quality of life (QoL) in patients with acute ischemic stroke (AIS) of varying severities remains limited, and how these factors influence QoL remains unclear. The aim of this study was to address this critical issue, refining treatments to enhance long-term QoL and optimize resource use. Methods In this multicenter prospective study conducted in China, patients with AIS were assessed using the EuroQol-5 Dimension (EQ-5D) questionnaire at admission and 1 year later. Univariate and multivariate analyses were conducted to identify QoL determinants. Motor function-related outcomes (MFRO) and non-motor function-related outcomes (NMFRO) were defined based on the EQ-5D questionnaire to explore how factors influence outcomes through mediation analysis. Results The study included 8598 patients with AIS (median age 64 years; 65.7% male), 3927 of whom had minor stroke severity (National Institutes of Health Stroke Scale [NIHSS] scores ≤ 3). The median QoL score improved from 0.597 at admission to 1.000 after 1 year. Compared to patients with minor stroke, more patients with non-minor stroke had non-motor function-related problems (NMFRP) at admission (78.2% vs. 56.6%). Age, stroke history, QoL at admission, infection, hospitalization costs, and discharge outcomes were found to be factors influencing QoL in both cohorts. In the non-minor stroke cohort, analysis revealed that additional factors include diabetes mellitus, geographical region, speech impairment, and thrombolysis, while in the minor stroke cohort, hypertension, coronary heart disease, cancer, prolonged length of stay, and hemorrhage were found to be relevant factors. The impact of most factors on QoL was mediated by MFRO, while the effects of age, speech impairment, and geographical region were also mediated by NMFRO. Hospitalization costs beyond 15,000 China Yuan (CNY) did not improve QoL for the patients with non-minor stroke, with a threshold of 10,000 CNY for the patients with minor stroke. Conclusions Over half of the patients in the study population had NMFRP, necessitating greater medical attention. Patients with different stroke severities had distinct QoL determinants. Age, speech impairment, and geographical region may exert an impact partly mediated through NMFRO. Higher hospitalization costs did not consistently improve QoL beyond a certain threshold. Trial Registration ClinicalTrials.gov Identifier: NCT02470624.https://doi.org/10.1007/s40120-025-00743-9Acute ischemic strokeDeterminantsQuality of lifeSocial economyNon-motor function related problems |
| spellingShingle | Yuxuan Lu Weiping Sun Yining Huang Zhaoxia Wang Zhiyuan Shen Wei Sun Ran Liu Fan Li Junlong Shu Qing Peng Jingjing Jia Peng Sun Yijun Song Haiqiang Jin CASTOR Investigators Comparison of Factors Affecting Quality of Life in Patients with Acute Ischemic Stroke Across Different Stroke Severities Neurology and Therapy Acute ischemic stroke Determinants Quality of life Social economy Non-motor function related problems |
| title | Comparison of Factors Affecting Quality of Life in Patients with Acute Ischemic Stroke Across Different Stroke Severities |
| title_full | Comparison of Factors Affecting Quality of Life in Patients with Acute Ischemic Stroke Across Different Stroke Severities |
| title_fullStr | Comparison of Factors Affecting Quality of Life in Patients with Acute Ischemic Stroke Across Different Stroke Severities |
| title_full_unstemmed | Comparison of Factors Affecting Quality of Life in Patients with Acute Ischemic Stroke Across Different Stroke Severities |
| title_short | Comparison of Factors Affecting Quality of Life in Patients with Acute Ischemic Stroke Across Different Stroke Severities |
| title_sort | comparison of factors affecting quality of life in patients with acute ischemic stroke across different stroke severities |
| topic | Acute ischemic stroke Determinants Quality of life Social economy Non-motor function related problems |
| url | https://doi.org/10.1007/s40120-025-00743-9 |
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