title: Long-term outcome after stroke: evaluating health-related quality of life using utility measurements.
abstract: OBJECTIVE
  As stroke mortality rates decline, individuals are increasingly likely to live with their residual impairments and disabilities. Therefore, the quality of poststroke life is 1 of the pivotal topics that have to be considered beneath the functional outcome. However, data on health-related quality of life (HRQoL) have been infrequently used in stroke trials. The purpose of this study was to examine the long-term outcome (4 years after stroke) of HRQoL and to identify the determinants of HRQoL in stroke survivors.
  
  
  METHODS
  Seventy-seven patients were included who were admitted to the Department of Neurology, Philipps-University Marburg, after experiencing an ischemic stroke, a transient ischemic attack, or a hemorrhagic stroke. All patients were examined by a physician, and assessment was performed using a standardized questionnaire. HRQoL was assessed using the German version of the EuroQoL Index (EQ-5D) and the Health Utility Index 2 and 3 (HUI2/3).
  
  
  RESULTS
  Four years after stroke, besides physical functioning, neuropsychological sequelae such as depression and cognitive impairment contributed to a reduced HRQoL. In addition, the incidence of incontinence proved to be an important factor for HRQoL. Explained variances in regression analysis models were high (R2=0.802 for HUI and 0.633 for EQ-5D--visual analogue scale) and were based on a few important determinants, including physical state, depression, cognitive impairment, and incontinence.
  
  
  CONCLUSIONS
  Our results underscore the importance of nonmotor symptoms on HRQoL in patients with stroke.
authors.affiliation: Department of Neurology, Philipps-University Marburg, Germany.
authors.forename: Caroline
authors.initials: C
authors.lastname: Haacke
authors.forename: Astrid
authors.initials: A
authors.lastname: Althaus
authors.forename: Annika
authors.initials: A
authors.lastname: Spottke
authors.forename: Uwe
authors.initials: U
authors.lastname: Siebert
authors.forename: Tobias
authors.initials: T
authors.lastname: Back
authors.forename: Richard
authors.initials: R
authors.lastname: Dodel
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D004185:Disability Evaluation; D005260:Female; D006304:Health Status; D006470:Hemorrhage; D006801:Humans; D007511:Ischemia; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D015999:Multivariate Analysis; D011788:Quality of Life; D012720:Severity of Illness Index; D020521:Stroke / Q000628:therapy*; D000071939:Stroke Rehabilitation; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome