Functional status and use of healthcare facilities in long-term survivors of transient ischaemic attack or minor ischaemic stroke.
BACKGROUND
Stroke may have a major effect on survivors and on the healthcare system.


OBJECTIVE
To study the functional status and use of healthcare facilities in long-term survivors of a transient ischaemic attack (TIA) or minor ischaemic stroke (MIS) and evaluate associations with baseline and follow-up characteristics.


METHODS
Follow-up of patients who had participated in the Dutch TIA Trial or the European Atrial Fibrillation Trial was extended to a mean period of 15.6 years. Patients were interviewed through a postal questionnaire (n = 468) and a sample of this group was also interviewed at home (n = 198). Demographic data, information on comorbidity, functional status (Barthel Index, Frenchay Activities Index and modified Rankin Scale) and use of healthcare facilities were recorded.


RESULTS
About one third of the survivors interviewed at home experienced any residual disability and 26% were moderately to severely handicapped. Factors associated with poor functional status were advanced age and the presence of any infarct on a baseline computed tomography scan, the recurrence of a new major stroke or the presence of comorbidity of locomotion. One third of survivors used any kind of professional care, which was predominantly related to the functional status at follow-up.


CONCLUSIONS
Recurrent stroke and the presence of comorbidity of locomotion are important determinants of long-term disability of survivors of a TIA or an MIS, which, in turn, is strongly associated with the long-term use of professional care. The need for measuring comorbidity with regard to functional status is recommended in research on stroke outcome.
van Wijk
I
I
Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Utrecht, The Netherlands.
Lindeman
E
E
Kappelle
L J
LJ
van Gijn
J
J
Koudstaal
P J
PJ
Gorter
J W
JW
Algra
A
A
D015897:Comorbidity; D006233:Persons with Disabilities; D005260:Female; D005500:Follow-Up Studies; D006268:Health Facilities / Q000706:statistics & numerical data*; D006304:Health Status; D006801:Humans; D002546:Ischemic Attack, Transient / Q000150:complications / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D019957:Motor Skills Disorders / Q000209:etiology; D012008:Recurrence; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation; D017741:Survivors