The impact of stroke characteristics on quality of life

Background: Stroke is one of the major cause of death and disability. Thirty percent of stroke subjects die within a year of cerebrovascular event and one third of survivors become dependent in daily living activities. The neurological deficits and disabilities along with cognitive, psychiatric and social changes can be destructive for the subjects and affect the life quality deeply. As the population is aging, stroke and related problems increase the global burden. Understanding the problems in daily activities and social environment of stroke patients and supporting them in this respect is important to improve their quality of life. Therefore, in recent years determining the factors associated with quality of life after the stroke and related studies has gained importance for improving quality of life. The most important items that assess the general quality of life include physical, functional, psychological and social dimension of health. Even though there are generic scales for assessing health-related quality of life in stroke, recently developed specific scales assess functional status and well-being beter and offer consistent information on the person's quality of life. This knowledge can modify the approach in poststroke period. Purpose: The present study aims to investigate the effects of stroke features such as, age, gender, stroke type, ischemic stroke subtype, stroke severity, therapy, lesion localization and lateralization; cognitive involvement; presence of depression; socio-cultural or economic factors, on stroke related quality of life by utilizing stroke specific quality of life scales. Materherials and metod: A total of 102 stroke subjects were included in the study. Subjects were evaluated in between the 3 to 6 months poststroke period. The demographical and stroke features were recorded. In the study; severity of stroke was assessed by National Institutes of Health Stroke Scale (NIHSS). Modified Rankin Scale (MRS) was used to determine disability levels, and cognitive status was evaluated by the Mini Mental State Test (MMST). Beck Depression Inventory (BDI) was used to reveal the presence of depression and to assess quality of life, Stroke Specific Quality of Life Scale (SSQOL) was used. The statistical analysis was performed with SPSS 15.0. Results: Severe stroke, presence of depression, advanced age and female gender are major determinants of decreased quality of life. Other factors can be listed as impaired cognition, use of anticoagulant drugs, lower education level and living alone. The type of stroke (hemorrhagic or ischemic), the subtypes of ischemic stroke, lateralization of stroke, and thrombolytic therapy do not affect the quality of life. Consclusion: There is a few studies investigating the stroke types (hemorrhagic or ischemic), subtypes of ischemic stroke (according to TOAST criteria) and stroke treatment impact on the quality of life. As the previous studies suggest, the major factors that affect the quality of life in early poststroke period include the severity of stroke, age, gender, the presence of depression, education level, cognitive status and living alone. Unlike other studies, our study supports that the treatment of stroke is also a determining factor for quality of life. Use of anticoagulant therapy affects the quality of life in negative way. In the present study, no difference was found between stroke subtypes and there was no effect of thrombolytic treatment on quality of life. Keywords: Depression, Disability, Health related quality of life, Health quality of life after stroke, Stroke, Stroke outcome