Assessment of health-related quality-of-life outcomes in patients diagnosed with acute ischemic stroke.

摘要

This study demonstrated how health-related quality of life (HRQL) assessments can be incorporated into two types of outcomes research: assessment of an investigational drug and a cost-utility analysis. A cross-sectional follow-up of 121 stroke patients was conducted to determine if there were long-term treatment group differences in HRQL, functional ability, global disability, and mortality and to explore the use of utility scores in a cost-utility analysis. Outcome variables included utility scores from administration of the Health Utilities Index (HUI2), functional ability from the Barthel Index (BI), and global disability and mortality from the Glasgow Outcome Scale (GOS). Scales were administered to proxy respondents over the telephone. Hypothesis testing and exploratory analyses were applied to determine treatment group differences and to ascertain the importance of independent variables on utility scores, component attributes, and survival. Of 121 patients, 26 (21%) died, 22 (18%) were lost to follow-up, and 73 (60%) survived an average 1.6 years after treatment. In interviews with 53 consented patients, no long-term treatment group differences were observed on any of the assessment scales. Death rates were comparable. There was marked variability in the frequency of HUI2 health states and corresponding utility scores. It took 47 health states to describe 53 survivors. Recurrent stroke and stroke severity were the variables most likely to influence overall utility score (