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. 2022 Nov 10:13:1023271.
doi: 10.3389/fneur.2022.1023271. eCollection 2022.

Higher comorbidity burden is associated with lower self-reported quality of life after stroke

Marlene Heinze  1 , Lisa Lebherz  2 , David Leander Rimmele  1 , Marc Frese  3 , Märit Jensen  1 , Ewgenia Barow  1 , Iris Lettow  1 , Levente Kriston  2 , Christian Gerloff  1 , Martin Härter  2 , Götz Thomalla  1
Affiliations

Higher comorbidity burden is associated with lower self-reported quality of life after stroke

Marlene Heinze et al. Front Neurol. .

Abstract

Introduction: This study assesses the association of comorbidity burden and polypharmacy with self-reported quality of life after stroke.

Patients and methods: We performed a post-hoc analysis of a prospective, single-center, observational study of outcome evaluation by patient-reported outcome measures in stroke clinical practice. Consecutive patients with acute ischemic stroke (AIS) were enrolled and self-reported health-related quality of life (HrQoL) was assessed 90 days after acute stroke using the Patient-reported Outcomes Measurement Information System 10-Question Short-Form (PROMIS-10). Comorbidities at baseline were assessed by the Charlson Comorbidity Index (CCI). Polypharmacy was defined as medication intake of ≥5 at baseline. We used linear regression analysis to study the association of CCI, polypharmacy and other clinical covariates with HrQoL after stroke.

Results: Of 781 patients (median age 76 years, 48.4% female) enrolled, 30.2% had a CCI Score ≥2, and 31.5% presented with polypharmacy. At follow up, 71 (9.1%) had died. In 409 (52.4%) reached for outcome evaluation, Global Physical Health T-Score was 43.8 ± 10 and Global Mental Health T-Score was 43.5 ± 8.76, indicating lower HrQoL than the average population. A CCI Score ≥2, higher NIHSS Score, female sex, dependency on others for dressing, toileting and mobility before index stroke, atrial fibrillation and hypertension were independent predictors of worse physical and mental health outcomes, while polypharmacy was not.

Conclusion: In patients with AIS, high comorbidity burden and polypharmacy are frequent. Comorbidity burden at admission is independently associated with worse self-reported physical and mental health three months after stroke.

Keywords: CCI; comorbidity burden; health-related quality of life; polypharmacy; stroke.

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Conflict of interest statement

Author CG reports personal fees from Amgen, Bayer Vital, Bristol-Myers Squibb, Boehringer Ingelheim, Sanofi Aventis, Abbott, and Prediction Biosciences outside the submitted work. Author GT reports receiving consulting fees from Acandis, grant support, and lecture fees from Bayer, Boehringer Ingelheim, Bristol-Myers Squibb/Pfizer and Daiichi Sankyo, and consulting fees and lecture fees from Stryker outside the submitted work. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Illustrates how many patients with acute ischemic stroke included in this study presented with a Charlson Comorbidity Index ≥ 2 at baseline.
Figure 2
Figure 2
Illustrates how many patients presented with a medication intake ≥ 5 at time of index stroke (baseline).
See this image and copyright information in PMC

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