Abstract W P322: Quality of Life Measurements in Patients with Transient Ischemic Attack and Minor Stroke
Background and Purpose: Transient ischemic attack (TIA) and minor ischemic stroke patients typically have no or negligible residual deficits or disability. We sought to evaluate patient-reported quality of life (QOL) at 3-months in patients with TIA or minor stroke with no residual deficits.
Methods: From a single-center prospective cohort study of ischemic stroke and transient ischemic attack (TIA) patients, we identified patients admitted between August 2012 and April 2013 with TIA and minor stroke 1) with no residual deficits, defined as NIHSS of 0 at 24 hours; 2) discharged home with modified Rankin Scale (mRS) < 2; and 3) without recurrent stroke prior to 3-month follow-up. Functional status was assessed by structured telephone interviews and patient-reported outcomes using Neuro-QOL and PROMIS short-form tests at 3 months. The modified Rankin scale (mRS), Barthel Index (BI), and 8 domains of QOL were measured: upper extremity (UE) function, lower extremity (LE) function, mobility, applied cognition-general concerns, applied cognition-executive function, depression, social satisfaction, and fatigue. We assessed the proportion with impaired QOL, defined as > 1 standard deviation from mean of 50 on T-scores for each QOL domain.
Results: Among 91 patients meeting our study criteria (mean age 65.9 years, 52% female, 67% white, median initial NIHSS score 0), mRS was 0 in 84.6% and 1 in 15.4% of patients at 3 months while BI was 100 and 95 in 94.5% and 5.5%, respectively. On QOL assessments, 6.6% had impaired UE function, 4.4% impaired mobility, and 8.8% any impaired physical function. Only 2.2% had abnormal cognitive, depression, fatigue, or social satisfaction scores. Any reported impairment of QOL was noted in 10 (11.0%) patients overall.
Conclusions: Despite having no disability on standard objective disability scales, over 10% of patients with TIA or minor stroke report a reduction in quality of life at 3 months. As they may be more sensitive to mild impairments, patient-reported physical and cognitive function may more useful as endpoints in future studies of TIA or minor stroke than standard disability rating scales.
Author Disclosures: F.Z. Caprio: None. C. Corado: None. D. Bergman: None. Y. Curran: None. R. Bernstein: Research Grant; Modest; Boehringer Ingelheim, Medtronic, Pfizer-BMS, Athersys. Speakers' Bureau; Modest; Medtronic. Consultant/Advisory Board; Modest; Janssen. Speakers' Bureau; Significant; Boehringer Ingelheim, BMS-Pfizer. D. Cella: None. A. Naidech: None. S. Prabhakaran: None.
- © 2014 by American Heart Association, Inc.