Abstract TP175: Lower Health-Related Quality of Life (HRQoL) At 3-6 Months After Stroke in Both Women and Men Compared to Those Without Stroke: An Observational Study From The Australian Stroke Clinical Registry (AuSCR)

Abstract

Introduction: Women appear to experience worse HRQoL after stroke than men. However, women without stroke also report poorer health status than men in all ages. Therefore, it is uncertain whether the sex disparity in HRQoL is caused by stroke or other differences between men and women. Methods: First-ever strokes admitted to 39 hospitals participating in AuSCR from 2010-2014, had HRQoL assessed at 3-6 months after stroke using EQ-5D-3L and results transformed into utility values for the respondents and among those who died, ranging from -0.516 (worse than death), 0 (death) to 1 (perfect health). Calculated mean EQ5D utility scores for stroke registrants were then stratified by age (<55, 55-64, 65-74 and 75+ years old) and sex. Mean utility (reference) scores of those without stroke in the corresponding age and sex groups were obtained from the South Australian population-based Health Omnibus Survey. We calculated the weighted age-standardized mean difference (MD) scores between those with stroke (AuSCR registrants) and without stroke (population norms), separately for men and women. The difference in weighted MD scores between men and women within the range 0.08-0.12 unit was defined as clinically meaningful. Results: After a median follow-up of 139 days, there were 2700 deaths out of 14118 registered cases of stroke. About 60% (6852/11418) of survivors after stroke completed follow-up surveys with EQ5D assessment; 44% being female. In the stroke group, only women aged > 65 years old had significantly lower utility scores than the elderly men of the same age. After standardisation for age, weighted MDs between those with and without stroke were slightly greater for women (MD 0.40 95% CI 0.37, 0.42) compared to men (MD 0.36 95% CI 0.34, 0.38. However, the sex difference in weighted utility scores between those with and without stroke (MD 0.04) was below the clinically meaningful threshold. Conclusion: Stroke causes substantial loss of HRQoL in both men and women especially with increasing age. However, the differences in utility scores between those men and women with and without stroke were not clinically relevant. Future studies of sex differences in HRQoL after stroke should consider the innate differences in HRQoL between men and women when reporting results.