Trajectories of post-stroke quality of life and long-term prognosis: Results from an eleven-year prospective study

• Published in: Journal of psychosomatic research Vol. 173; p. 111466
• Main Authors: Hu, Meijing, Zhang, Baiyang, Lin, Yidie, Xu, Minghan, Zhu, Cairong
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.10.2023
• Subjects: Prognosis; Quality of life; Stroke; Trajectory; Stroke; Prognosis; Trajectory; Quality of life
• ISSN: 0022-3999; 1879-1360
• DOI: 10.1016/j.jpsychores.2023.111466

The relationship between quality of life (QoL) and long-term prognosis in stroke patients is still unclear. We explored physical and mental QoL trajectories during the first six months after stroke and determined the associations between trajectories and long-term prognosis in patients with first-ever ischemic stroke. Included were 733 participants from a prospective study. QoL was assessed with the 12-item Short Form Survey (SF-12) at baseline, 3 and 6 months. Patients' prognoses (stroke recurrence and death) were identified from 2010 to 2021. The latent class growth model (LCGM) was used to identify distinct trajectories of physical and mental QoL measured over the first 6 months. We employed the Cox model or Fine-Gray model for prognoses to examine the associations between QoL trajectories and prognosis. Five trajectories of physical QoL and five trajectories of mental QoL were identified. For physical QoL of the Poor-Improved, and Moderate-Impaired trajectory versus Moderate-Improved trajectory, the hazard ratio (HR) for death was 2.39 (1.14 to 5.02), and 2.03(0.93 to 4.44); the HR for recurrence was 1.56 (0.83 to 2.94) and 2.33 (1.28 to 4.24). For mental QoL of the Moderate-Impaired trajectory versus the Moderate-Improved trajectory, the HR for death was 2.48 (1.21 to 5.07). The results were robust in the sensitivity analysis. QoL during the first six months after ischemic stroke can be categorized into distinct groups. Change in QoL was associated with long-term survival. Secondary prevention of recurrent strokes might rely more on improving patients' physical QoL. •QoL during the first six months after stroke can be categorized into distinct groups.•Resilience is common; treatment is still needed.•Change in QoL was associated with long-term survival.•The prevention of recurrent strokes might rely more on patients' physical QoL.