title: Factors influencing prognosis and functional outcome one year after a first-time stroke in a Caribbean population.
abstract: OBJECTIVE
  To evaluate functional outcome and quality of life 1 year poststroke in a Caribbean population.
  
  
  METHODS
  Prospective study of patients with a first hemispheric stroke admitted consecutively between December 2010 and February 2011. The patients were evaluated (1) in the emergency department, (2) when discharged from the hospital, and (3) 1 year poststroke.
  
  
  METHODS
  A university hospital.
  
  
  METHODS
  Of the 140 consecutive patients with stroke, 78 (42% women, 24.4% hemorrhagic stroke) were included in the study.
  
  
  METHODS
  None.
  
  
  METHODS
  Patients were evaluated using the National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), FIM, and Medical Outcomes Study 36-Item Short-Form Health Survey.
  
  
  RESULTS
  The mean age of the participants was 62.1±17.7 years; 70.5% of patients had hypertension, 29.4% had diabetes, and 23.6% had chronic renal failure. At 1 year poststroke, the mortality rate was 29.4%, and the recurrence rate 2.6%. We evaluated 39 of the 55 survivors (71%). Score evolution (emergency department vs 1y later) is as follows: for the NIHSS, it was 6.2±4.9 versus 3.3±3.9 (z=-3.578; P<.001); and for the mRS score ≤2, it was 54.2% versus 66.7% (χ(2)=14.182; P=.25). The FIM score on discharge from the hospital versus 1 year later was 103.2±28.2 versus 101.7±31.5 (z=-1.008; P=.313). Multivariate analysis showed that aphasia, hemianopia, and incontinence significantly influenced the 1-year FIM score (P<.001). Quality of life, a patient-reported outcome measure of health-related quality of life, was significantly altered concerning vitality, role physical, and role emotional.
  
  
  CONCLUSIONS
  One year after a first stroke, despite significant improvement of neurologic impairment, the level of dependency did not change and quality of life was altered. Aphasia, hemianopia, and incontinence significantly influenced functional state.
authors.affiliation: Physical Medicine and Rehabilitation Department, University Hospital of Pointe-à-Pitre, Guadeloupe, French West Indies.
authors.forename: Sophie
authors.initials: S
authors.lastname: Galanth
authors.affiliation: CIC-EC Antilles Guyane CIE 802 Inserm, Guadeloupe, French West Indies.
authors.forename: Benoit
authors.initials: B
authors.lastname: Tressieres
authors.affiliation: Neurology Department, University Hospital of Pointe-à-Pitre, Guadeloupe, French West Indies; Antilles Guyane University, 97159 Pointe-à-Pitre, Guadeloupe, French West Indies; Sorbonne Pierre and Marie Curie University Paris 06, Inserm, CNRS, UM 75, U1127, ICM, Paris, France.
authors.forename: Annie
authors.initials: A
authors.lastname: Lannuzel
authors.affiliation: Physical Medicine and Rehabilitation Department, University Hospital of Pointe-à-Pitre, Guadeloupe, French West Indies.
authors.forename: Patrick
authors.initials: P
authors.lastname: Foucan
authors.affiliation: Neurology Department, University Hospital of Pointe-à-Pitre, Guadeloupe, French West Indies; ECM/LAMIA EA4540, Antilles Guyane University, 97159 Pointe-à-Pitre, Guadeloupe, French West Indies. Electronic address: cosmin.alecu@chu-guadeloupe.fr.
authors.forename: Cosmin
authors.initials: C
authors.lastname: Alecu
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D001037:Aphasia / Q000209:etiology; D017691:Caribbean Region / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006423:Hemianopsia / Q000209:etiology; D006429:Hemiplegia / Q000209:etiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D056128:Obesity, Abdominal / Q000453:epidemiology; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology; D012008:Recurrence; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology; D057185:Sedentary Behavior; D020521:Stroke / Q000150:complications* / Q000401:mortality / Q000503:physiopathology*; D015996:Survival Rate
keywords: Outcome assessment (health care); Quality of life; Recovery of function; Rehabilitation; Stroke