Association between in-hospital frailty and health-related quality of life after stroke: the Nor-COAST study

BACKGROUND: Stroke survivors are known to have poorer health-related quality of life (HRQoL) than the general population, but less is known about characteristics associated with HRQoL decreasing through time following a stroke. This study aims to examine how in-hospital frailty is related to HRQoL f...

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Autores principales: Wæhler, Idunn Snorresdatter, Saltvedt, Ingvild, Lydersen, Stian, Fure, Brynjar, Askim, Torunn, Einstad, Marte Stine, Thingstad, Pernille
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7931593/
https://www.ncbi.nlm.nih.gov/pubmed/33663430
http://dx.doi.org/10.1186/s12883-021-02128-5
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author Wæhler, Idunn Snorresdatter
Saltvedt, Ingvild
Lydersen, Stian
Fure, Brynjar
Askim, Torunn
Einstad, Marte Stine
Thingstad, Pernille
author_facet Wæhler, Idunn Snorresdatter
Saltvedt, Ingvild
Lydersen, Stian
Fure, Brynjar
Askim, Torunn
Einstad, Marte Stine
Thingstad, Pernille
author_sort Wæhler, Idunn Snorresdatter
collection PubMed
description BACKGROUND: Stroke survivors are known to have poorer health-related quality of life (HRQoL) than the general population, but less is known about characteristics associated with HRQoL decreasing through time following a stroke. This study aims to examine how in-hospital frailty is related to HRQoL from 3 to 18 months post stroke. METHOD: Six hundred twenty-five participants hospitalised with stroke were included and followed up at 3 and/or 18 months post stroke. Stroke severity was assessed the day after admission with the National Institutes of Health Stroke Scale (NIHSS). A modified Fried phenotype was used to assess in-hospital frailty; measures of exhaustion, physical activity, and weight loss were based on pre-stroke status, while gait speed and grip strength were measured during hospital stay. HRQoL at 3- and 18-months follow-up were assessed using the five-level version of the EuroQol five-dimensional descriptive system (EQ-5D-5L) and the EuroQol visual analogue scale (EQ-5D VAS). We conducted linear mixed effect regression analyses unadjusted and adjusted for sex, age, and stroke severity to investigate the association between in-hospital frailty and post-stroke HRQoL. RESULTS: Mean (SD) age was 71.7 years (11.6); mean NIHSS score was 2.8 (4.0), and 263 (42.1%) were female. Frailty prevalence was 10.4%, while 58.6% were pre-frail. The robust group had EQ-5D-5L index and EQ-5D VAS scores at 3 and 18 months comparable to the general population. Also at 3 and 18 months, the pre-frail and frail groups had significantly lower EQ-5D-5L indices than the robust group (p <  0.001), and the frail group showed a larger decrease from 3 to 18 months in the EQ-5D-5L index score compared to the robust group (− 0.056; 95% CI − 0.104 to − 0.009; p = 0.021). There were no significant differences in change in EQ-5D VAS scores between the groups. CONCLUSION: This study on participants mainly diagnosed with mild strokes suggests that robust stroke patients have fairly good and stable post-stroke HRQoL, while post-stroke HRQoL is impaired and continues to deteriorate among patients with in-hospital frailty. This emphasises the importance of a greater focus on frailty in stroke units. TRIAL REGISTRATION: ClinicalTrials.gov (NCT02650531).
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spelling pubmed-79315932021-03-05 Association between in-hospital frailty and health-related quality of life after stroke: the Nor-COAST study Wæhler, Idunn Snorresdatter Saltvedt, Ingvild Lydersen, Stian Fure, Brynjar Askim, Torunn Einstad, Marte Stine Thingstad, Pernille BMC Neurol Research Article BACKGROUND: Stroke survivors are known to have poorer health-related quality of life (HRQoL) than the general population, but less is known about characteristics associated with HRQoL decreasing through time following a stroke. This study aims to examine how in-hospital frailty is related to HRQoL from 3 to 18 months post stroke. METHOD: Six hundred twenty-five participants hospitalised with stroke were included and followed up at 3 and/or 18 months post stroke. Stroke severity was assessed the day after admission with the National Institutes of Health Stroke Scale (NIHSS). A modified Fried phenotype was used to assess in-hospital frailty; measures of exhaustion, physical activity, and weight loss were based on pre-stroke status, while gait speed and grip strength were measured during hospital stay. HRQoL at 3- and 18-months follow-up were assessed using the five-level version of the EuroQol five-dimensional descriptive system (EQ-5D-5L) and the EuroQol visual analogue scale (EQ-5D VAS). We conducted linear mixed effect regression analyses unadjusted and adjusted for sex, age, and stroke severity to investigate the association between in-hospital frailty and post-stroke HRQoL. RESULTS: Mean (SD) age was 71.7 years (11.6); mean NIHSS score was 2.8 (4.0), and 263 (42.1%) were female. Frailty prevalence was 10.4%, while 58.6% were pre-frail. The robust group had EQ-5D-5L index and EQ-5D VAS scores at 3 and 18 months comparable to the general population. Also at 3 and 18 months, the pre-frail and frail groups had significantly lower EQ-5D-5L indices than the robust group (p <  0.001), and the frail group showed a larger decrease from 3 to 18 months in the EQ-5D-5L index score compared to the robust group (− 0.056; 95% CI − 0.104 to − 0.009; p = 0.021). There were no significant differences in change in EQ-5D VAS scores between the groups. CONCLUSION: This study on participants mainly diagnosed with mild strokes suggests that robust stroke patients have fairly good and stable post-stroke HRQoL, while post-stroke HRQoL is impaired and continues to deteriorate among patients with in-hospital frailty. This emphasises the importance of a greater focus on frailty in stroke units. TRIAL REGISTRATION: ClinicalTrials.gov (NCT02650531). BioMed Central 2021-03-04 /pmc/articles/PMC7931593/ /pubmed/33663430 http://dx.doi.org/10.1186/s12883-021-02128-5 Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Wæhler, Idunn Snorresdatter
Saltvedt, Ingvild
Lydersen, Stian
Fure, Brynjar
Askim, Torunn
Einstad, Marte Stine
Thingstad, Pernille
Association between in-hospital frailty and health-related quality of life after stroke: the Nor-COAST study
title Association between in-hospital frailty and health-related quality of life after stroke: the Nor-COAST study
title_full Association between in-hospital frailty and health-related quality of life after stroke: the Nor-COAST study
title_fullStr Association between in-hospital frailty and health-related quality of life after stroke: the Nor-COAST study
title_full_unstemmed Association between in-hospital frailty and health-related quality of life after stroke: the Nor-COAST study
title_short Association between in-hospital frailty and health-related quality of life after stroke: the Nor-COAST study
title_sort association between in-hospital frailty and health-related quality of life after stroke: the nor-coast study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7931593/
https://www.ncbi.nlm.nih.gov/pubmed/33663430
http://dx.doi.org/10.1186/s12883-021-02128-5
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