Open AccessHealth-related quality of life loss associated with first-time stroke
Author(s) -
Yen Shing Yeoh,
Gerald ChoonHuat Koh,
Chuen Seng Tan,
Tian Ming Tu,
Rajinder Singh,
Hui Meng Chang,
Deidre Anne De Silva,
Yee Sien Ng,
Yan Hoon Ang,
Philip Yap,
Effie Chew,
Reshma Aziz Merchant,
Tseng Tsai Yeo,
Ning Chou,
Narayanaswamy Venketasubramanian,
Kim En Lee,
Sherry Young,
Helen Hoenig,
David B. Matchar,
Nan Luo
Publication year - 2019
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0211493
Subject(s) - stroke (engine) , medicine , quality of life (healthcare) , depression (economics) , population , physical therapy , anxiety , psychiatry , mechanical engineering , nursing , environmental health , engineering , economics , macroeconomics
Objectives This study aimed to quantify health-related quality of life (HRQoL) loss associated with first episode of stroke by comparing patient-reported HRQoL before and after stroke onset. The impact of stroke in local population was also evaluated by comparing the pre- and post-stroke HRQoL with that of the general population. Methods The HRQoL of stroke survivors was assessed with the EQ-5D-3L index score at recruitment, for recalled pre-stroke HRQoL, and at 3 and 12 month post-stroke. Change in HRQoL from pre-stroke to 3 and 12 month was self-reported by 285 and 238 patients, respectively. Mean EQ index score at each time point (baseline: 464 patients; 3 month post-stroke: 306 patients; 12 month post-stroke: 258 patients) was compared with published population norms for EQ-5D-3L. Results There was a significant decrease in HRQoL at 3 (0.25) and 12 month (0.09) post-stroke when compared to the retrospectively recalled patients’ mean pre-stroke HRQoL level (0.87). The reduction at 3 month was associated with the reduction in all EQ-5D-3L health dimensions; reductions remaining at 12 month were limited to dimensions of mobility, self-care, usual activities, and anxiety/depression. Stroke patients had a lower mean EQ index than the general population by 0.07 points pre-stroke (0.87 vs. 0.94), 0.33 points at 3 month (0.61 vs. 0.94) and 0.18 points at 12 month (0.76 vs. 0.94) post-stroke. Conclusions Stroke has a substantial impact on HRQoL in Singapore, especially in the first three months post-stroke. Compared to the general population, stroke survivors have lower HRQoL even before stroke onset. This pre-stroke deficit in HRQoL should be taken into account when quantifying health burden of stroke or setting goals for stroke rehabilitation.