Profiles of patients’ self-reported health after acute stroke
Abstract Background We aimed to identify groups of patients with similar health status after stroke, assessed by patient reported outcome measures (PROMs), to improve initial risk stratification. Methods In a prospective study, inpatients were recruited during acute stroke treatment. Demographics, h...
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| Format: | Article |
| Language: | English |
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BMC
2021-08-01
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| Series: | Neurological Research and Practice |
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| Online Access: | https://doi.org/10.1186/s42466-021-00146-9 |
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| author | D. Leander Rimmele Theresa Schrage Lisa Lebherz Levente Kriston Christian Gerloff Martin Härter Götz Thomalla |
| author_facet | D. Leander Rimmele Theresa Schrage Lisa Lebherz Levente Kriston Christian Gerloff Martin Härter Götz Thomalla |
| author_sort | D. Leander Rimmele |
| collection | DOAJ |
| description | Abstract Background We aimed to identify groups of patients with similar health status after stroke, assessed by patient reported outcome measures (PROMs), to improve initial risk stratification. Methods In a prospective study, inpatients were recruited during acute stroke treatment. Demographics, history, and cardio-vascular risk factors were assessed at baseline. Self-reported functional status, physical and mental health as well as anxiety and depressive symptoms were assessed 3 and 12 months after stroke and used to identify latent classes. The association of patient characteristics with latent class membership was investigated with multinomial logistic regression. Results Of the 650 patients included with a mean age of 75 years and 48% female, 70% had ischemic, 6% hemorrhagic strokes, and 24% transient ischemic attacks. Median NIHSS on admission was 2 (IQR:0,5). Values of PROMs remained comparable at 3 and 12 months. A three-class model was developed, differentiating between patients with mildly (75%), moderately (17%), and severely (8%) impaired self-reported health status. Adjusted for univariately significant baseline characteristics, initial NIHSS distinguished mild- from moderate-, and moderate- from severe-class-membership (p < 0.001). Length of inpatient stay (p < 0.001;OR = 1.1), diabetes (p = 0.021;OR = 1.91), and atrial fibrillation (p = 0.004;OR = 2.20) predicted allocation to the moderately vs. mildly affected class. Conclusions Grading stroke patients by a standard set of PROMs up to 1 year after stroke allows to distinguish the diverse impact of baseline characteristics on differently affected groups. In addition to initial stroke severity, longer inpatient stay, presence of diabetes and atrial fibrillation correlate with greater impairment of self-reported health in the less affected groups. Trial registration http://www.ClinicalTrials.gov ; Unique identifier: NCT03795948 . |
| first_indexed | 2024-12-19T14:55:20Z |
| format | Article |
| id | doaj.art-008ef760b17349a8bcc73750d771cbcf |
| institution | Directory Open Access Journal |
| issn | 2524-3489 |
| language | English |
| last_indexed | 2024-12-19T14:55:20Z |
| publishDate | 2021-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Neurological Research and Practice |
| spelling | doaj.art-008ef760b17349a8bcc73750d771cbcf2022-12-21T20:16:43ZengBMCNeurological Research and Practice2524-34892021-08-01311910.1186/s42466-021-00146-9Profiles of patients’ self-reported health after acute strokeD. Leander Rimmele0Theresa Schrage1Lisa Lebherz2Levente Kriston3Christian Gerloff4Martin Härter5Götz Thomalla6Department of Neurology, University Medical Center Hamburg-EppendorfDepartment of Medical Psychology, University Medical Center Hamburg-EppendorfDepartment of Medical Psychology, University Medical Center Hamburg-EppendorfDepartment of Medical Psychology, University Medical Center Hamburg-EppendorfDepartment of Neurology, University Medical Center Hamburg-EppendorfDepartment of Medical Psychology, University Medical Center Hamburg-EppendorfDepartment of Neurology, University Medical Center Hamburg-EppendorfAbstract Background We aimed to identify groups of patients with similar health status after stroke, assessed by patient reported outcome measures (PROMs), to improve initial risk stratification. Methods In a prospective study, inpatients were recruited during acute stroke treatment. Demographics, history, and cardio-vascular risk factors were assessed at baseline. Self-reported functional status, physical and mental health as well as anxiety and depressive symptoms were assessed 3 and 12 months after stroke and used to identify latent classes. The association of patient characteristics with latent class membership was investigated with multinomial logistic regression. Results Of the 650 patients included with a mean age of 75 years and 48% female, 70% had ischemic, 6% hemorrhagic strokes, and 24% transient ischemic attacks. Median NIHSS on admission was 2 (IQR:0,5). Values of PROMs remained comparable at 3 and 12 months. A three-class model was developed, differentiating between patients with mildly (75%), moderately (17%), and severely (8%) impaired self-reported health status. Adjusted for univariately significant baseline characteristics, initial NIHSS distinguished mild- from moderate-, and moderate- from severe-class-membership (p < 0.001). Length of inpatient stay (p < 0.001;OR = 1.1), diabetes (p = 0.021;OR = 1.91), and atrial fibrillation (p = 0.004;OR = 2.20) predicted allocation to the moderately vs. mildly affected class. Conclusions Grading stroke patients by a standard set of PROMs up to 1 year after stroke allows to distinguish the diverse impact of baseline characteristics on differently affected groups. In addition to initial stroke severity, longer inpatient stay, presence of diabetes and atrial fibrillation correlate with greater impairment of self-reported health in the less affected groups. Trial registration http://www.ClinicalTrials.gov ; Unique identifier: NCT03795948 .https://doi.org/10.1186/s42466-021-00146-9StrokePatient-reported outcome measuresValue-based health careICHOM, PROMIS |
| spellingShingle | D. Leander Rimmele Theresa Schrage Lisa Lebherz Levente Kriston Christian Gerloff Martin Härter Götz Thomalla Profiles of patients’ self-reported health after acute stroke Neurological Research and Practice Stroke Patient-reported outcome measures Value-based health care ICHOM, PROMIS |
| title | Profiles of patients’ self-reported health after acute stroke |
| title_full | Profiles of patients’ self-reported health after acute stroke |
| title_fullStr | Profiles of patients’ self-reported health after acute stroke |
| title_full_unstemmed | Profiles of patients’ self-reported health after acute stroke |
| title_short | Profiles of patients’ self-reported health after acute stroke |
| title_sort | profiles of patients self reported health after acute stroke |
| topic | Stroke Patient-reported outcome measures Value-based health care ICHOM, PROMIS |
| url | https://doi.org/10.1186/s42466-021-00146-9 |
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