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Changes in functional outcome over five years after stroke
Högskolan Väst, Institutionen för hälsovetenskap, Avdelningen för omvårdnad - avancerad nivå. Department of Medicine, Skaraborg Hospital Skövde, Skövde, Sweden.ORCID-id: 0000-0002-6454-9575
Research and Development Centre, Skaraborg Hospital Skövde, Skövde, Sweden.
Department of Health and Social Care, Municipality of Lidköping, Sweden.
Department of Medicine, Skaraborg Hospital Skövde, Skövde, Sweden.
Vise andre og tillknytning
2019 (engelsk)Inngår i: Brain and Behavior, ISSN 2162-3279, E-ISSN 2162-3279, Vol. 9, nr 6, artikkel-id e01300Artikkel i tidsskrift (Fagfellevurdert) Published
Abstract [en]

Objectives: Data on the long‐term time course of poststroke functional outcome is limited. We investigated changes in functional outcome over 5 years after stroke in a hospital based cohort.

Materials and Methods: Consecutive patients who were independent in activities of daily living (ADL) and admitted to a Stroke Unit at Skaraborg Hospital, Sweden for a first acute stroke from 2007 to 2009 (n = 1,421) were followed‐up after 3 months and thereafter annually over 5 years using a postal questionnaire. Clinical variables at acute stroke and 3 months post stroke were obtained from the Swedish Stroke Register. ADL dependency was defined as dependence in dressing, toileting or indoor mobility.

Results: The proportions of survivors who reported ADL dependency remained stable throughout follow‐up (19%–22%). However, among survivors who were ADL independent at 3 months, about 3% deteriorated to dependency each year. Deterioration was predicted by age (HR 1.11; 95% CI 1.08–1.13), diabetes (HR 1.65; 95% CI 1.12–2.44), NIHSS score (HR 1.07; 95% CI 1.04–1.10), and self‐perceived unmet care needs one year post stroke (HR 2.01; 95% CI 1.44–2.81). Transitions from ADL dependency to independence occurred mainly during the first year post stroke. Improvement was negatively predicted by living alone before stroke (HR 0.41 95% CI 0.19–0.91), NIHSS score (HR 0.90; 95% CI 0.86–0.95) and ischemic stroke (vs. hemorrhagic stroke), HR 0.39; 95% CI 0.17–0.89.

Conclusion: Transitions between ADL independence and dependency occur up to 5 years after stroke. Some of the factors predicting these transitions are potentially modifiable

sted, utgiver, år, opplag, sider
2019. Vol. 9, nr 6, artikkel-id e01300
Emneord [en]
functional outcome, quality register, longitudinal study, stroke
HSV kategori
Forskningsprogram
VÅRD- OCH HÄLSOVETENSKAP, Vårdvetenskap
Identifikatorer
URN: urn:nbn:se:hv:diva-13860DOI: 10.1002/brb3.1300ISI: 000471830600006Scopus ID: 2-s2.0-85067551531OAI: oai:DiVA.org:hv-13860DiVA, id: diva2:1317848
Merknad

Funders: Skaraborg Institute for Research and Development, (06-1045);Medical Fund at the Skaraborg Hospital; the Research Fund at the Skaraborg Hospital;the Skaraborg Research and Development Council; and the Swedish stroke association

Tilgjengelig fra: 2019-05-24 Laget: 2019-05-24 Sist oppdatert: 2020-02-03bibliografisk kontrollert

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