Self-rated health over the first five years after stroke

Area of Science:

• Neurology
• Rehabilitation Medicine
• Patient-Reported Outcomes

Background:

• Self-rated health (SRH) is a crucial patient-reported outcome reflecting an individual's perception of their health status.
• Understanding SRH post-stroke is vital for assessing long-term recovery and quality of life.

Purpose of the Study:

• To investigate self-rated health (SRH) in stroke survivors from 1 to 5 years post-stroke.
• To analyze the longitudinal changes in SRH over time.
• To identify factors associated with good SRH after stroke.

Main Methods:

• A cohort of 2190 stroke patients admitted to Swedish Stroke Units between 2007-2009 were followed for 5 years.
• Patient-reported outcomes, including SRH (assessed via SF-36 general health question), were collected annually via postal questionnaires.
• Multiple logistic regression analysis was employed to identify factors associated with SRH.

Main Results:

• The proportion of stroke survivors reporting good SRH gradually increased from 40.2% at 1 year to 46.3% at 5 years.
• Activities of daily living (ADL) performance was strongly linked to SRH; 49.8% of independent survivors reported good SRH versus 14.7% of dependent survivors at 1 year.
• In independent survivors, good SRH was associated with female sex, physical activity, and car driving, while negatively associated with age, pain, depression, and unmet care needs. Similar patterns were observed in dependent survivors, with depression and age being negatively associated with SRH.

Conclusions:

• Stroke survivors show a slight increase in reporting good self-rated health over the 5-year follow-up period.
• Post-stroke SRH is significantly associated with pain, depression, functional ability (ADL), and perceived unmet care needs.
• Interventions in the chronic phase of stroke recovery should focus on addressing pain, depression, functional limitations, and care needs to improve patient-reported health outcomes.