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Changes in functional outcome over five years after stroke
University West, Department of Health Sciences, Section for nursing - graduate level. 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.
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2019 (English)In: Brain and Behavior, ISSN 2162-3279, E-ISSN 2162-3279, Vol. 9, no 6Article in journal (Refereed) 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

Place, publisher, year, edition, pages
John Wiley & Sons, 2019. Vol. 9, no 6
Keywords [en]
functional outcome, quality register, longitudinal study, stroke
National Category
Nursing
Research subject
NURSING AND PUBLIC HEALTH SCIENCE, Nursing science
Identifiers
URN: urn:nbn:se:hv:diva-13860DOI: 10.1002/brb3.1300OAI: oai:DiVA.org:hv-13860DiVA, id: diva2:1317848
Note

First published: 07 May 2019

Available from: 2019-05-24 Created: 2019-05-24 Last updated: 2019-07-24Bibliographically approved

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Rejnö, Åsa

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