Health related quality of life in stroke patients and risk factors associated with patients for return to work

Abstract

To clarify dynamic change of quality of life (QOL) in patients with stroke after treatment, and to explore the predictors associated with return to work (RTW) within 48 weeks.Patients diagnosed with stroke were enrolled. All patients enrolled were asked to fill in the Short Form 36 Health Survey. For patients with stroke, SF-36 questionnaires were measured repeatedly 4 weeks after treatment. We used phone call to find out if the patient was RTW. The investigation time was 48 weeks.Patients with stroke had lower scores in terms of physiological dimensions, such as physical functional, role limitations due to physical problems, and general health (P < .001). While patients with strokes scored significantly lower in all mental dimensions including vitality, social functioning, role limitations due to emotional problems, and mental health (P < .001). After 4-weeks treatment, we found that, except for bodily pain, scores in dimensions like physical functioning, role limitations due to physical problems, and general health had increased significantly (P < .001). Multivariate logistic regression analysis was conducted, and the result showed that older age (P = .04) and singleness (P = .03) were risk factors associated with QOL improvement in stroke patients after treatment. Outcomes of stroke patients within 48 weeks were explored. The results showed that 108 out of 136 patients RTW within 48 weeks. Average days it took for patients with cerebral infarction to return to work were 77 ± 79, significantly less than patients with cerebral hemorrhage (206 ± 159 days) and patients with subarachnoid hemorrhage (117 ± 113 days, P < .001). Multivariate analysis indicated that only QOL improvement (P = .04) and subtype of stroke (P = .01) were independent factors associated with RTW within 48 weeks.QOL of stroke patients was significantly reduced. After treatments, the physiological quality of stroke patients increased, but the psychological quality remained low. In addition, patients with cerebral hemorrhage and patients with no significant improvement in QOL are independent risk factors for RTW. Therefore, for this subgroup of the population, early diagnosis, close follow-up and monitor of the psychological state should be provided to avoid the occurrence of adverse events.

Figure 1

SF-36 scores in stroke patients and controls. Patients with stroke had lower scores in terms of physiological dimensions, such as physical functional, role limitations due to physical problems and general health (P < .001). While patients with strokes scored significantly lower in mental dimensions including vitality, social functioning, role limitations due to emotional problems and mental health (P < .001). BP = bodily pain, ERF = emotional role functioning, GHP = general health perceptions, MH = mental health, PF = physical functioning, PFR = physical role functioning, SRF = social role functioning, VIT = vitality,.

Figure 2

SF-36 Scores for patient before and after treatment. We investigated the QOL of the stroke patients repeatedly 4 weeks after the treatment. We found that at the physiological level, except for bodily pain, scores in dimensions like physical functioning, role limitations due to physical problems and general health had increased significantly (P < .001). BP = bodily pain, ERF = emotional role functioning, GHP = general health perceptions, PF = physical functioning, PFR = physical role functioning SRF = social role functioning, MH = mental health, VIT = vitality.

Figure 3

The days from diagnosis to RTW in stokes patients. The average days it took for patients with cerebral infarction to return to work were 77 ± 79 days, significantly less than patients with cerebral hemorrhage (206 ± 159 days) and patients with subarachnoid hemorrhage (117 ± 113 days, P < .001). RTW = return to work.