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

Abstract

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.