Satisfaction with quality of life poststroke:: Effect of sex differences in pain response

Objective: To study the relationship between sex differences among men and women in the response to pain and the effect on satisfaction with quality of life (QOL) in poststroke patients approximately 90 days after discharge from inpatient medical rehabilitation. Design: Cross-sectional design. Setting: Community based. Participants: The sample included 1724 patients (877 men, 847 women) aged 40 years and older with a history of stroke, according to information obtained from the IT HealthTrack database. The average age was 68.7 years; 79.3% were non-Hispanic white. Interventions: Not applicable. Main Outcome Measure: Satisfaction with QOL. Results: Pain ratings for both the men and the women were significant and inversely associated with satisfaction with QOL after adjustments for possible confounding factors. However, among men with stroke, each 1-point increase in pain rating was associated with an 18% decreased odds of being satisfied with QOL (odds ratio [OR],.81; 95% confidence interval [CI],.77-86). Conversely, among women with stroke, each 1-point increase in pain rating was associated with an 11% decreased odds of being satisfied with QOL (OR=.89; 95% CI, .84-95). Conclusions: Our data indicate that pain after stroke is significantly associated with reduced satisfaction with QOL, particularly among men. Increased awareness and treatment of pain may improve satisfaction with QOL. Our findings suggest that sex differences and pain response are clinically important factors in examining satisfaction with QOL in the poststroke population.