Determinants of quality of life in Brazilian stroke survivors

Objective: To identify the main determinants of health-related quality of life (HRQoL) in Brazilian stroke survivors. Methods: Patients were assessed with the NIH Stroke Scale, Barthel index (BI), Lawton scale, modified-Rankin scale, Cumulative Illness Rating Scale for Geriatrics, Mini-Mental State Examination, Hospital Anxiety and Depression Scale, and Stroke Impact Scale (SIS) 3.0. Results: 260 stroke survivors were assessed (mean age: 55.9 years; 55.2% males). Eighty-eight per cent of patients had an ischemic infarction. Approximately one third (31.5%) had a BI score <= 60 (severe disability), and 34.5% were independent in the activities of daily living. Prevalence of post-stroke depression was significantly higher in females than in males (25% vs 15.4%; p = 0.05). Post-stroke depression was associated with female sex, disability, and lower cognitive functioning (p < 0.001). SIS Physical Composite Domain mean score was 46.6. Hand Function (26.5), Strength (47.6), Mobility (50.1), Social participation (50.6), and Emotion (52.2) were the most affected domains. HRQoL of stroke survivors decreased in a significant way as motor impairment severity, disability, functional status and mood worsened (ANOVA, p < 0.0001). Motor impairment, disability, and mood disturbances were independent predictors of HRQoL in the multivariate regression analysis. Conclusions: Post-stroke depression and disability are consistent determinants of HRQoL in Brazilian stroke patients. (C) 2009 Elsevier B. V. All rights reserved.