Determinants of Self-Rated Health Three Months after Stroke

Self-rated health is an important aspect of life after stroke. The aim of this study was to compare self-rated health in a population of stroke patients to the general Danish population and to analyze to what extent clinical and patient-related factors influence self-rated health 3 months after stroke.

We sent questionnaires on self-rated health (Short Form-12 Health Survey) to all patients younger than 80 years with first-time stroke admitted to any hospital in the Central Denmark Region between October 1, 2008, and December 31, 2011 (N = 2414). Information on clinical and patient-related determinants of self-rated health was obtained from population-based national health registers.

Compared to the general population, stroke patients rated their health lower than the general Danish population. The largest differences were found in domains of physical health, and only minor differences were identified in mental health between the study and the general Danish population. Stroke severity, comorbidity, smoking, educational level, and age were strongly associated with self-reported health. For patients with a "very severe" stroke, the adjusted odds ratios (ORs) of reduced mental health were 1.6 (95% confidence interval [CI]: 1.3-2.6) and 5.1 (95% CI: 2.7-9.6) for low physical health, compared to patients with "mild stroke." Patients with a Charlson Comorbidity Index score of 3 or higher had a higher risk of low mental health (OR 1.9 [95% CI: 1.3-2.6]) and low physical health (OR 2.8 [95% CI: 1.9-4.0]) than patients with no additive diseases.

Stroke had a marked impact of self-rated health, particularly physical health. Higher stroke severity and level of comorbidity were important risk factors of reduced self-rated health.