Persisting consequences of ischemic stroke after three months, assessed with the Stroke Impact Scale Version 3.0

ABSTRACT

Introduction

Acute ischemic stroke (AIS) has a significant impact on different aspects of the patient’s life resulting in loss of independence and poor Health-related Quality of life (HR-QoL).

Aims

This study aimed to evaluate the impact of AIS on HR-QoL during the first three months post-stroke in a defined Bulgarian population.

Methods

A total of 150 patients with AIS – 50 with thrombolytic and 100 with non-thrombolytic therapy, were enrolled in a hospital-based study at a tertiary care referral center for neurological disorders in Bulgaria. The HR-QoL of stroke survivors was assessed with the Stroke Impact Scale 3.0 on discharge, in the first and the third-month post-stroke.

Results

The overall HR-QoL remained significantly reduced during the observation period. The most affected domains in the third-month were Participation, Hand function, Mobility, Strenght, and Activities of daily living (ADL). Improvement in all HR-QoL domains was found, most pronounced up to the first-month post-stroke. The higher age, NIHSS and mRS scores were associated with worse SIS 3.0 scores. Left-hemispheric AIS was associated with worse Memory and Communication outcomes, while Right-hemispheric lesions had a higher impact on the Emotions. Large-artery occlusion determined diminished Strenght scores, whereas cardioembolism impacted Communication and ADL domains. Contrarily, lacunar stroke showed more favourable outcomes in all domains.

Conclusion

There is the utmost need to focus on the long-term effects of ischemic stroke, due to the rising number of patients who live with the consequences of stroke. Stroke treatment should not be directed exclusively to acute stroke care or prevention, but also to optimizing the post-stroke functioning and Quality of life.

KEYWORDS:

• Health-related Quality of life
• Quality of life
• ischemic stroke
• Cerebral Infaction
• Stroke
• Stroke Impact Scale
• SIS 3.0
• Bulgaria

Acknowledgement

The authors are grateful to all patients included in this study for their support, cooperation, and agreement to use their clinical data for the current publication. The authors would also like to thank the editorial board of Neurological Research for review and criticism in improving the manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

Funding This research did not receive any specific grant from funding agencies inpublic, commercial, or not-for-profit sectors.

Notes on contributors

Mihael Tsalta-Mladenov

Mihael Tsalta-Mladenov, MD, PhD is a resident in Second Clinic of Neurology with ICU and stroke unit at the University Hospital “St. Marina”, Varna, Bulgaria, and assistant professor at the department of “Neurology and neuroscience”, at The Medical University “Prof. Dr. Paraskev Stoyanov”, Varna, Bulgaria.

Silva Andonova

Silva Andonova MD, PhD, DSc is a professor and head of the department of “Neurology and neuroscience”, at the Medical University “Prof. Dr. Paraskev Stoyanov”, Varna, Bulgaria, and Director of the University Hospital “St. Marina”, Varna,Bulgaria.