Quality of Life 6 Months after Acute Stroke: Impact of Initial Treatment in a Stroke Unit and General Medical Wards

Abstract

Background and Purpose: Few studies have assessed the influence of the organization of stroke care on health-related quality of life (HRQoL). The present study compared HRQoL 6 months after stroke between subjects who had been treated in an acute stroke unit (SU) and those treated in general medical wards (GMW). Methods: In total 550 subjects≧60 years of age with acute stroke were prospectively allocated according to date of birth (day of the month) to treatment in an SU with short length of stay or GMWs. In the present study, 325 survivors at 5 days with Scandinavian stroke scale (SSS) orientation score >5 and SSS speech score >5 were included. We assessed HRQoL with the Short Form 36 (SF-36) questionnaire 6 months after stroke onset and estimated utility values from the SF-36 scores. Results: Of the 325 eligible subjects, 158 were allocated to an SU and 167 to GMWs. Among 296 survivors at 6 months, 115 subjects (79% of survivors) in the SU group completed the questionnaire and 121 (80%) in the GMW group. There was no statistically significant difference between the treatment groups on any of the 8 SF-36 scales or the 2 component summary scales. After integrating death in the comparison of HRQoL, there was still no difference in outcome between the groups. Conclusion: An acute SU with a short length of stay, offering early treatment and rehabilitation, could not show an improvement in the HRQoL of stroke patients ≧60 years 6 months after stroke compared with initial treatment in GMWs.