Predicting Domain-Specific Health-Related Quality of Life Using Acute Infarct Volume

Chen Lin*, Jungwha Lee, Neil Chatterjee, Carlos Corado, Timothy Carroll, Andrew Naidech, Shyam Prabhakaran

*Corresponding author for this work

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

Background and Purpose - Limited data exist on the relationship between acute infarct volume and health-related quality of life (HRQOL) measures after ischemic stroke. We evaluated whether acute infarct volume predicts domain-specific Neuro-Quality of Life scores at 3 months after stroke. Methods - Between 2012 and 2014, we prospectively enrolled consecutive patients with ischemic stroke and calculated infarct volume. Outcome scores at 3 months included modified Rankin Scale and Neuro-Quality of Life T scores. We evaluated whether volume organized by quartiles predicted modified Rankin Scale and HRQOL scores at 3 months using logistic and linear regression as appropriate, adjusting for relevant covariates. We calculated variance accounted for (R 2) overall and by volume for each domain of HRQOL. Results - Among 490 patients (mean age 64.2±15.86 years; 51.2% male; 63.3% White) included for analysis, 58 (11.8%) were disabled (modified Rankin Scale score of >2) at 3 months. In unadjusted analysis, the highest volume quartile remained a significant predictor of 1 HRQOL domain, applied cognition-general concerns (R 2 =0.06; P<0.001). Our fully adjusted prediction model explained 32% to 51% of the variance in HRQOL: upper extremity (R 2 =0.32), lower extremity (R 2 =0.51), executive function (R 2 =0.45), and general concerns (R 2 =0.34). Conclusions - Acute infarct volume is a poor predictor of HRQOL domains after ischemic stroke, with the exception of the cognitive domain. Overall, clinical and imaging variables explained <50% of the variance in HRQOL outcomes at 3 months. Our data imply that a broad range of factors, some known and others undiscovered, may better predict poststroke HRQOL than what is currently available.

Original languageEnglish (US)
Pages (from-to)1925-1931
Number of pages7
JournalStroke
Volume48
Issue number7
DOIs
StatePublished - Jul 1 2017

Keywords

  • cognition
  • lower extremity
  • magnetic resonance imaging
  • patient outcome assessment
  • quality of life
  • stroke

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing

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