Quality of life after stroke. Impact of stroke type and lesion location

Abstract

Background and purpose: Little attention has been focused on the relationship between neurological lesions and quality of life (QL) in stroke research. The purpose of this study was to analyze the impact of stroke types and lesion locations on QL.

Methods: The study sample was composed of 441 stroke patients. Lesion locations and stroke types were divided into 194 left-sided and 173 right-sided lesions, 61 infratentorial strokes (55 infarctions and 6 hemorrhages), and 335 supratentorial strokes (204 [sub]cortical infarctions, 82 lacunar infarctions, and 49 hemorrhages). Six months after stroke, QL was assessed with the Sickness Impact Profile. Age-adjusted QL scores were expressed in standard scores.

Results: Although patients with left-sided lesions had more speech pathology (P < .001), there was slightly more QL deterioration in patients with right-sided lesions. Patients with infratentorial strokes reported better overall functioning than patients with supratentorial strokes (P = .02). Patients with lacunar infarction had less dysfunction compared to patients with (sub)cortical lesions (P < .001). There was no difference in QL between supratentorial (sub)cortical infarcts and hemorrhages. Lesion locations and stroke types did not affect patients' emotional distress. Severely impaired QL patterns were related significantly to older age (P < .001), comorbidity (P = .02), stroke severity (P < .001), and supratentorial lesions (P = .02).

Conclusions: There is only a weak relationship between lesion laterality and QL. Survivors of hemorrhagic strokes do not evidence more QL impairment than survivors of ischemic strokes. Stroke per se is not unequivocally followed by emotional discomfort. In addition to stroke type, patient and clinical characteristics are also important in explaining impaired QL patterns.