Clinical Symptom Profiles After Mild-Moderate Stroke.

Background There is heterogeneity in the severity of domains affected in patients with stroke, resulting in differences in health-related quality of life (hrQoL). Identifying different clinical profiles of stroke patients may provide a means for selecting patients for tailored interventions to improve hrQoL. Methods and Results This was an observational study of 496 patients with ischemic stroke or intracerebral hemorrhage seen in a cerebrovascular clinic from October 12, 2015, through June 11, 2018, who completed patient-reported outcome measures using Patient-Reported Outcome Measurement Information System (PROMIS) tools within 1 month of stroke. Latent profile analysis identified groups based on PROMIS domain scores-pain, depression, cognitive function, fatigue, social role satisfaction, and physical function-as well as clinician-reported modified Rankin Scale ( mRS ). Five distinct profiles were identified. Group 1 ("excellent hrQoL," n=106) had fewer symptoms in all domains than the general population. Group 2 ("disabled with mixed hrQoL," n=17) had fewer symptoms than the general population in all domains except social role satisfaction and physical function, despite having moderate disability (median mRS score: 3). Group 3 ("mild limitations with average hrQoL," n=189) had scores similar to the general population for all domains and minimal disability (median mRS score: 1). Group 4 ("mild limitations with poor hrQoL," n=152) also had a median mRS score of 1 but had worse scores than group 3 on all domains. Group 5 ("disabled with poor hrQoL," n=32) had worse symptoms than patients in the other profiles and a median mRS score of 3. Conclusions Patients with recent stroke have distinct clinical symptom profiles, even with similar levels of clinician-reported disability. Symptom profiles provide a means of understanding patterns of outcomes in patients with stroke.