Patient-reported outcomes across cerebrovascular event types: More similar than different

Irene L Katzan1, Andrew Schuster2, Christopher Newey2

  • 1From the Neurological Institute Center for Outcomes Research & Evaluation (I.L.K., A.S., B.L.) and Cerebrovascular Center (I.L.K. C.N., K.U.), Cleveland Clinic, OH. Katzani@ccf.org.

Neurology
|November 2, 2018
PubMed

Insights

Patients with transient ischemic attack (TIA) experienced worse health outcomes across multiple domains compared to other stroke types. Physical function, social roles, and executive function were most impacted across all cerebrovascular events.

Area of Science:

  • Neurology
  • Public Health
  • Health Outcomes Research

Background:

  • Cerebrovascular events significantly impact patient health across various domains.
  • Understanding differential health domain effects by stroke subtype is crucial for targeted interventions.

Purpose of the Study:

  • To compare the impact of different cerebrovascular event types (ischemic stroke, intracerebral hemorrhage, subarachnoid hemorrhage, TIA) on 8 health domains.
  • To identify factors associated with health domain scores across these event types.

Main Methods:

  • Observational cohort study of 2,181 patients with ischemic stroke, ICH, SAH, or TIA.
  • Utilized Quality of Life in Neurologic Disorders and Patient-Reported Outcomes Measurement Information System scales.
  • Assessed physical function, social roles, executive function, fatigue, anxiety, depression, pain interference, and sleep disturbance.

Main Results:

  • Ischemic stroke, ICH, and SAH showed similar health domain impacts after adjustment.
  • Transient ischemic attack (TIA) patients had significantly worse adjusted scores in 5 of 8 health domains.
  • Female sex, younger age, lower income, and recent events (<90 days) correlated with poorer outcomes.

Conclusions:

  • Stroke subtype significantly influences health domain outcomes, with TIA patients experiencing worse adjusted results.
  • Physical function, satisfaction with social roles, and executive function are the most affected domains across all cerebrovascular events.
  • Findings suggest distinct outcome mechanisms for TIA and underscore the need for targeted interventions.
Abstract

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