Determinants of quality of life in Brazilian stroke survivors.
OBJECTIVE
To identify the main determinants of health-related quality of life (HRQoL) in Brazilian stroke survivors.


METHODS
Patients were assessed with the NIH Stroke Scale, Barthel index (BI), Lawton scale, modified-Rankin scale, Cumulative Illness Rating Scale for Geriatrics, Mini-Mental State Examination, Hospital Anxiety and Depression Scale, and Stroke Impact Scale (SIS) 3.0.


RESULTS
260 stroke survivors were assessed (mean age: 55.9 years; 55.2% males). Eighty-eight per cent of patients had an ischemic infarction. Approximately one third (31.5%) had a BI score < or = 60 (severe disability), and 34.5% were independent in the activities of daily living. Prevalence of post-stroke depression was significantly higher in females than in males (25% vs 15.4%; p=0.05). Post-stroke depression was associated with female sex, disability, and lower cognitive functioning (p<0.001). SIS Physical Composite Domain mean score was 46.6. Hand Function (26.5), Strength (47.6), Mobility (50.1), Social participation (50.6), and Emotion (52.2) were the most affected domains. HRQoL of stroke survivors decreased in a significant way as motor impairment severity, disability, functional status and mood worsened (ANOVA, p<0.0001). Motor impairment, disability, and mood disturbances were independent predictors of HRQoL in the multivariate regression analysis.


CONCLUSIONS
Post-stroke depression and disability are consistent determinants of HRQoL in Brazilian stroke patients.
Department of Neurology, The Sarah Network of Rehabilitation Hospitals, Sarah Hospital, Brasilia DF, Brazil. fjavier4644@terra.com.br
Francisco Javier
FJ
Carod-Artal
Daniele Stieven
DS
Trizotto
Luciane Ferreira
LF
Coral
Clarissa Menezes
CM
Moreira
D000328:Adult; D000368:Aged; D001925:Brain Damage, Chronic / Q000453:epidemiology / Q000209:etiology / Q000523:psychology; D001938:Brazil; D003072:Cognition Disorders / Q000453:epidemiology / Q000209:etiology; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology / Q000209:etiology; D006233:Persons with Disabilities / Q000523:psychology*; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology / Q000209:etiology; D011446:Prospective Studies; D011788:Quality of Life; D020127:Recovery of Function; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications / Q000453:epidemiology / Q000523:psychology*; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data