Side matters: differences in functional outcome and quality of life after thrombectomy in left and right hemispheric stroke.
Health-related quality of life
Real world
Stroke
Thrombectomy
Journal
Neurological research and practice
ISSN: 2524-3489
Titre abrégé: Neurol Res Pract
Pays: England
ID NLM: 101767802
Informations de publication
Date de publication:
21 Nov 2022
21 Nov 2022
Historique:
received:
08
08
2022
accepted:
12
10
2022
entrez:
21
11
2022
pubmed:
22
11
2022
medline:
22
11
2022
Statut:
epublish
Résumé
Patients with a left (LHS) or right hemispheric stroke (RHS) differ in terms of clinical symptoms due to lateralization of specific cortical functions. Studies on functional outcome after stroke and endovascular thrombectomy (EVT) comparing both hemispheres showed conflicting results so far. The impact of stroke laterality on patient-reported health-related quality of life (HRQoL) after EVT has not yet been adequately addressed and still remains unclear. Consecutive stroke thrombectomy patients, derived from a multi-center, prospective registry (German Stroke Registry) between June 2015 and December 2019, were included in this study. At 90 days, outcome after EVT was assessed by the modified Rankin scale (mRS) and HRQoL using the European QoL-five dimensions questionnaire utility-index (EQ-5D-I; higher values indicate better HRQoL) in patients with LHS and RHS. Adjusted regression analysis was applied to evaluate the influence of stroke laterality on outcome after EVT. In total, 5683 patients were analyzed. Of these, 2953 patients (52.8%) had LHS and 2637 (47.2%) RHS. LHS patients had a higher baseline NIHSS (16 vs. 13, p < 0.001) and a higher ASPECTS (9 vs. 8, p < 0.001) compared to RHS patients. Among survivors, patients with LHS less frequently had a self-reported affected mobility (p = 0.037), suffered less often from pain (p = 0.04) and anxiety/depression (p = 0.032) three months after EVT. After adjusting for confounders (age, sex, baseline NIHSS), LHS was associated with a better HRQoL (ß coefficient 0.04, CI 95% 0.017-0.063; p = 0.001), and better functional outcome assessed by lower values on the mRS (ß coefficient - 0.109, CI 95% - 0.217-0.000; p = 0.049). Ninety days after EVT, LHS patients have a better functional outcome and HRQoL. Patients with RHS should be actively assessed and treated for pain, anxiety and depression to improve their HRQoL after EVT.
Sections du résumé
BACKGROUND
BACKGROUND
Patients with a left (LHS) or right hemispheric stroke (RHS) differ in terms of clinical symptoms due to lateralization of specific cortical functions. Studies on functional outcome after stroke and endovascular thrombectomy (EVT) comparing both hemispheres showed conflicting results so far. The impact of stroke laterality on patient-reported health-related quality of life (HRQoL) after EVT has not yet been adequately addressed and still remains unclear.
METHODS
METHODS
Consecutive stroke thrombectomy patients, derived from a multi-center, prospective registry (German Stroke Registry) between June 2015 and December 2019, were included in this study. At 90 days, outcome after EVT was assessed by the modified Rankin scale (mRS) and HRQoL using the European QoL-five dimensions questionnaire utility-index (EQ-5D-I; higher values indicate better HRQoL) in patients with LHS and RHS. Adjusted regression analysis was applied to evaluate the influence of stroke laterality on outcome after EVT.
RESULTS
RESULTS
In total, 5683 patients were analyzed. Of these, 2953 patients (52.8%) had LHS and 2637 (47.2%) RHS. LHS patients had a higher baseline NIHSS (16 vs. 13, p < 0.001) and a higher ASPECTS (9 vs. 8, p < 0.001) compared to RHS patients. Among survivors, patients with LHS less frequently had a self-reported affected mobility (p = 0.037), suffered less often from pain (p = 0.04) and anxiety/depression (p = 0.032) three months after EVT. After adjusting for confounders (age, sex, baseline NIHSS), LHS was associated with a better HRQoL (ß coefficient 0.04, CI 95% 0.017-0.063; p = 0.001), and better functional outcome assessed by lower values on the mRS (ß coefficient - 0.109, CI 95% - 0.217-0.000; p = 0.049).
CONCLUSIONS
CONCLUSIONS
Ninety days after EVT, LHS patients have a better functional outcome and HRQoL. Patients with RHS should be actively assessed and treated for pain, anxiety and depression to improve their HRQoL after EVT.
Identifiants
pubmed: 36411484
doi: 10.1186/s42466-022-00223-7
pii: 10.1186/s42466-022-00223-7
pmc: PMC9677692
doi:
Types de publication
Journal Article
Langues
eng
Pagination
58Investigateurs
C Gerloff
(C)
J Fiehler
(J)
G Thomalla
(G)
A Alegiani
(A)
None Boeckh-Behrens
Silke Wunderlich
(S)
Ulrike Ernemann
(U)
Sven Poli
(S)
Eberhard Siebert
(E)
Christian H Nolte
(CH)
Sarah Zweynert
(S)
Georg Bohner
(G)
Alexander Ludolph
(A)
Karl-Heinz Henn
(KH)
Jan Hendrik Schäfer
(JH)
Fee Keil
(F)
Joachim Röther
(J)
Bernd Eckert
(B)
Jörg Berrouschot
(J)
Albrecht Bormann
(A)
Franziska Dorn
(F)
Gabor Petzold
(G)
Christoffer Kraemer
(C)
Hannes Leischner
(H)
Christoph Trumm
(C)
Steffen Tiedt
(S)
Lars Kellert
(L)
Martina Petersen
(M)
Florian Stögbauer
(F)
Michael Braun
(M)
Gerhard F Hamann
(GF)
Klaus Gröschel
(K)
Timo Uphaus
(T)
Arno Reich
(A)
Omid Nikoubashman
(O)
Peter Schellinger
(P)
Jan Borggrefe
(J)
Jörg Hattingen
(J)
Jan Liman
(J)
Marielle Ernst
(M)
Informations de copyright
© 2022. The Author(s).
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