Abstract WP140: Infarct Location Predicts Quality of Life Outcomes After Minor Stroke
Introduction: Neuro-QOL was developed to provide researchers with a continuous, validated, patient-reported measurement of quality of life. Previous studies suggest that minor ischemic stroke (MIS) can lead to disability and impaired quality of life in a substantial proportion of patients. We hypothesized that infarct location predicts 3-month QOL in patients with MIS.
Methods: We identified MIS (NIHSS ≤ 5) with confirmed acute infarcts on DWI, admitted between August 2012 and July 2013, and who underwent Neuro-QOL outcomes assessments at 3 months. Impaired QOL was defined as T-scores >0.5 SD worse than the general population mean of 50 (SD 10) in any of 5 domains: upper extremity, lower extremity, executive functions, general concerns, and social satisfaction. We analyzed the relationship between acute infarct locations and impaired QOL in univariate and multivariate analysis. We further stratified our analysis by any rehabilitation services (RS) received post-discharge.
Results: Among 169 patients (mean age 64.3 years, 54.4% male, 24.9% black, median initial NIHSS score 1, 36.7% received RS post-stroke), impaired QOL was noted in 56 (33.1%) patients at 3 months (56.5% in patient with vs. 19.6% in those without RS, p<0.001). Patients with left hemispheric infarcts (45.8 vs. 20.9%, p=0.001) and thalamic-brainstem infarcts were more likely to have impaired QOL (54.1 vs. 27.3%, p=0.002). In multivariable analysis, left hemispheric (adj. OR 3.45, 95% 1.61-7.41) and thalamic-brainstem infarction (adj. OR 4.59, 95% CI 1.91-11.00) were independent predictors of impaired QOL adjusting for age, NIHSS score, and recurrent stroke. Stratifying by RS, left hemispheric (34.0% vs 8.3% p=0.001) and thalamic-brainstem lesion location (52.6% vs 12.5% p<0.001) was significantly associated with QOL only in those who did not receive RS.
Discussion: Left hemispheric and thalamic-brainstems infarcts were independently associated with impaired QOL, especially in MIS patients who did not receive rehabilitation services post-stroke. These data imply that specific acute infarct locations predict patient-reported impairments in QOL and may be useful biomarkers for future studies of targeted rehabilitation services in MIS patients.
Author Disclosures: R.S. Sangha: None. R. Bernstein: None. D. Cella: None. C. Corado: None. Y. Curran: None. A. Naidech: None. I. Ruff: None. S. Prabhakaran: None.
- © 2016 by American Heart Association, Inc.