July 2018: Rudberg et al (2018) Long-term health-related quality of life, survival and costs by different levels of functional outcome six-months after stroke, European Stroke Journal, 3(2), 157-164. https://doi.org/10.1177/2396987317753444
OK, so I admit, I’m on a bit of a roll! This is my second article on “quality of life” (QoL) and they’ve been in consecutive months. Therefore, I promise that I won’t do QoL again, in 2018, at least. However, I’m certainly not apologising for my selection because essentially, isn’t this is what all healthcare relating to stroke is about? Whatever we do or don’t do in the management of those diagnosed with stroke, must have something to do with the person’s quality of life. I would propose that the most important outcome after stroke must be QoL. What’s interesting about Rudberg et al’s (2018) article is that functional level at 6 months was highly predictive of QoL and long-term survival at 3 years. This longitudinal study makes for very interesting reading, and it is readily available at http://journals.sagepub.com/doi/abs/10.1177/2396987317753444
To view the Abstract, go to the Journal Club 2018 link. To find just “Humble Opinion”, please see my comment below.
This study is based in Sweden and follows a cohort of 297 patients, linking outcome data to national data. The researchers don’t only investigate functional and survival outcomes, they also investigate implications relating to costs. I agree with them when they state that “Having reliable estimates of costs by functional outcomes will be valuable for health economic evaluations and for the planning of health care”. We know that once a person has experienced stroke, it’s impact is present for the rest of their lives. Its important to not only understand how best to distribute health resources in the first few hours and days, it is also important to understand this across the entire journey.
This study has some interesting findings relating to age, the OHS (Oxford Handicap Scale), gender and the cumulative mean costs in Table 3. Yet again, as occurs in so many of the stroke research, the National Institute of Health Stroke Scale (NIHSS) makes an important contribution to the analyses. Yet again, we can see the ongoing impact and burden of care associated with more severe stroke. The researchers in their conclusions, echo what we would all agree with, the significance of “Effective interventions aimed at reducing short-term disability levels..”
As with many of the investigations that report findings in countries with national patient registers, this one makes for very interesting reading indeed, in my humble opinion. As with all of these articles, its important you read it for yourself.
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