Factors affecting health-related quality of life assessed with the SF-36v2 health survey in outpatients with chronic-stage ischemic stroke in Japan--cross-sectional analysis of the OASIS study.

摘要

BACKGROUND AND PURPOSE: The number of chronic-stage ischemic stroke patients in Japan continues to increase, because of decreasing mortality. This study was designed to ascertain health-related quality of life (HRQOL) in ischemic stroke patients and to analyze in detail factors affecting HRQOL. METHODS: 2,069 outpatients (1,226 males, 843 females; mean age: 71 years; median duration after onset: 20.5 months) with chronic-stage ischemic stroke visiting 150 institutions in Japan were enrolled. HRQOL was evaluated using the second version of the patient self-administered Medical Outcome Study 36-Item Short-Form Health Survey (SF-36v2) questionnaire. RESULTS: All 8 domain scores and the physical component summary (PCS) score of SF-36v2 in stroke patients were significantly lower than those of Japanese national norms (JNN). The PCS score (36.6 +/- 16.1) and mental component summary (MCS) score (50.0 +/- 10.2) were lower than those of age-matched JNN (p < 0.001). Age, modified Rankin Scale (mRS), duration after onset and Japan Stroke Scale Depression score (JSS-D) were significantly correlated with PCS, as were role limitation because of physical problem, bodily pain, vitality and role limitation because of emotional problem scores; duration after onset and JSS-D were significantly correlated with MCS. Negative factors for PCS were older age, higher mRS, presence of subjective symptoms, neurological signs, rehabilitation and concomitant antidepressants. Negative factors for MCS were presence of subjective symptoms, psychiatric signs and concomitant antidepressants. CONCLUSIONS: HRQOL scores in ischemic stroke patients (chronic stage) are significantly correlated with not only age, mRS, duration after onset and JSS-D, but also presence of subjective symptoms and neurological/psychiatric signs, which could be targets for treatment.