Abstract 2237: Gender and Quality of Life after Ischemic Stroke: The Adherence eValuation After Ischemic stroke_Longitudinal (AVAIL) Registry
Background: Multiple studies have shown that women have poorer quality of life (QOL) than men after stroke. We hypothesized that women would have lower QOL scores measured with the EuroQOL-5D (EQ5D) up to 1 year after ischemic stroke than men in the AVAIL cohort, a large, nationally representative, observational registry.
Methods: After excluding proxy responses (n= 190), lost-to-follow-up (n= 62), and missing EQ5D scores (n=77), this analysis included 2,450 patients with ischemic stroke or TIA enrolled at 99 sites participating in the GWTG program. Baseline and 3 month sociodemographic and clinical data were compared by gender. EQ5D, a 5-item measure that assesses self-reported mobility, self care, usual activities, pain/discomfort, and anxiety/depression, was obtained at 3 and 12 months via telephone by centrally located and trained interviewers. A mixed effect multivariable model of EQ5D (primary outcome at record level) at 3 and 12 months was performed with gender and other relevant covariates as fixed effects and patient ID as the random effect.
Results: Women were older than men (mean 65.8 versus 64.2 years). At three months, women were less likely to have household income meet needs (68.4% vs. 72.5%), to be married (47.7% vs. 69.3%), working (31.8% vs. 47.8%), or ambulating at discharge (66.9% vs. 71.7%) than men. Women were more likely to be living alone (30.1% vs 18.3%), and were discharged on more medications (mean 7.2 vs. 6.6; p=0.0006), but men were more likely to have > 4 risk factors (15.4% vs. 11.1%; p<.0001). The EQ5D score was lower in women (median 0.80, IQR 0.71-0.85) than men (median 0.83, IQR 0.71-1.00; p<.0001), indicating poorer QOL. However, in the multivariable model, gender was not independently associated with EQ5D, whereas decreased number of risk factors, discharge home, ambulating at discharge, being married, living alone, working vs. home not by choice, having an adequate income, lower number of medications at discharge, not having rehab, and having insurance were all significant (Table). There was no evidence of a significant interaction between gender and living status in the multivariable model (p=0.128).
Conclusions: In this cohort, QOL was independently associated with socioeconomic status, disability, marital status, number of medications, and comorbidities, but not gender.
- © 2012 by American Heart Association, Inc.