| Abstract: | Objectives: Few studies have estimated the dynamicchanges and lifetimescores of quality of life (QOL) among differenttypes of ischemicstroke. The aim of this study was to quantify these to assist clinical decision. Methods: The hospital-based cohort, which consisted of 10,102 patients with first-ever ischemicstroke during 1995-2007, was classified into 5 types: large artery atherosclerosis (LAA), lacune, cardioembolism, other determined, and undetermined etiologies. After linking with the National Mortality Registry 1995-2008, survival function were determined and extrapolated over a 600-month period based on the survival ratio between the patient's and age- and sex- matched reference group's survival as estimated by a semi-parametric method and hazard functions taken from the vital statistics of Taiwan. WHOQOL-BREF questionnaire were administered on a cross-sectional sample of 748 patients to estimate the dynamicchanges along different duration-to-dates. The survival functions were then multiplied with different facet scores of QOL to obtain the lifetimescores for patients with differenttypes of ischemicstroke. Multiple regression analyses were conducted to explore the effects of different risk factors for QOL after adjustments for age, sex, and education. Results: Patients with LAA seemed to be affected the most in both survival and many facets of QOL, as demonstrated by lifetimescores of 35.6 (2.8), 31.7 (3.2), 32.7 (2.5) and 33.2 (3.2) score-months in mobility, positive feelings, sexual activity and participation in and opportunities for recreation or leisure, respectively. Compared with other types, cardio-embolism appeared to be affected the most over mobility, activities of daily living, work ability, thinking and learning. Conclusions:Among differenttypes of ischemicstroke, LAA seemed the worst in both QOL and survival; cardio-embolism showed the longest survival but poor QOL, indicating a possible greater demand for long term care. |
