급성 뇌졸중으로 입원한 환자의 1년 후 임상 지표와 건강 관련 삶의 질 비교: 일개 병원 기반의 뇌졸중 등록 체계에 등록된 환자를 중심으로
One-Year Health Related Quality of Life and Its Comparison With Various Clinical and Functional Scale in Hospitalized Patients With Acute Ischemic Stroke: Seoul National University Bundang Stroke Registry Study
1
조회
0
다운로드
9
인용
0
참고문헌
키워드
초록
Background: Knowing the magnitude of a problem is the first step to improving it, and quantifying the healthrelated quality of life (HRQOL) allows us to do it with respect to stroke. To identify the HRQOL in patients with ischemic stroke and its affecting factors, and compare it with other clinical and functional scales. Methods: A consecutive series of patients with acute ischemic stroke (AIS) or transient ischemic attack (TIA) was recruited. Their HRQOL and utilities were assessed using the EQ-5Dindex－which evaluates the health profile of an individual in five dimensions (mobility, self-care, usual activity, pain/discomfort, and anxiety/depression) and three levels (no problem, some/moderate problems, and extreme problems)－at 1 year after stroke. The Modified Rankin Scale (MRS), Barthel Index (BI), and NIH Stroke Scale (NIHSS) were used to measure clinical and functional statuses. The EQ-5Dindex and the clinical and functional statuses were compared by clinical parameters, and the relationships among those scales were examined. Additionally, the EQ-5Dindex in the patients was compared with that in age- and sex-matched healthy controls. Results: Among 538 patients with AIS or TIA, 465 patients (males, 59.8%; age, 65.3±11.8 [mean±SD]; TIA, 7.7%; and initial NIHSS, 4.5±5.1) were evaluated. The EQ-5Dindex and the clinical and functional statuses were clearly aggravated by age, but did not differ with most of the risk factors. The EQ-5Dindex was strongly and significantly correlated with scores on the MRS, BI, and NIHSS. The EQ-5Dindex was lower in patients (especially older ones) than in healthy controls. Conclusions: This study shows that the EQ-5D is a feasible and valid tool for measuring HRQOL in patients with AIS or TIA.
Abstract
Background: Knowing the magnitude of a problem is the first step to improving it, and quantifying the healthrelated quality of life (HRQOL) allows us to do it with respect to stroke. To identify the HRQOL in patients with ischemic stroke and its affecting factors, and compare it with other clinical and functional scales. Methods: A consecutive series of patients with acute ischemic stroke (AIS) or transient ischemic attack (TIA) was recruited. Their HRQOL and utilities were assessed using the EQ-5Dindex－which evaluates the health profile of an individual in five dimensions (mobility, self-care, usual activity, pain/discomfort, and anxiety/depression) and three levels (no problem, some/moderate problems, and extreme problems)－at 1 year after stroke. The Modified Rankin Scale (MRS), Barthel Index (BI), and NIH Stroke Scale (NIHSS) were used to measure clinical and functional statuses. The EQ-5Dindex and the clinical and functional statuses were compared by clinical parameters, and the relationships among those scales were examined. Additionally, the EQ-5Dindex in the patients was compared with that in age- and sex-matched healthy controls. Results: Among 538 patients with AIS or TIA, 465 patients (males, 59.8%; age, 65.3±11.8 [mean±SD]; TIA, 7.7%; and initial NIHSS, 4.5±5.1) were evaluated. The EQ-5Dindex and the clinical and functional statuses were clearly aggravated by age, but did not differ with most of the risk factors. The EQ-5Dindex was strongly and significantly correlated with scores on the MRS, BI, and NIHSS. The EQ-5Dindex was lower in patients (especially older ones) than in healthy controls. Conclusions: This study shows that the EQ-5D is a feasible and valid tool for measuring HRQOL in patients with AIS or TIA.
참고문헌 (29)
- Asplund K, "From the twentieth to Dthe twenty-first century: a public health perspective on stroke. In: Cerebrovascular isease Pathophysiology, Diagnosis, and Mangement" (1988), Blackwell Science
- Rankin J, "Cerebral vascular accidents in patients over the age of 60. Ⅱ", Prgrosis. Scott Med J, 2, pp.200~215 (1957)
- Bonita R, "Recovery of motor function after stroke", Stroke, 19, pp.1947~1500 (1988)
- Mahoney FI, "Functional evaluation: the Barthel index", Md State Med J, 14, pp.61~65 (1965)
- Drummond MF, "Methods for the Economic evaluation of health care programes. 3rd ed" (2005), Oxford University Press
- Patric DL, "Methods for measuring levels of well-being for a health status index", Health Serv Res, 8, pp.228~245 (1973)
- Kaplan RM, "The general health policy model: update and applications", Health Serv Res, 23, pp.203~235 (1988)
- Torrance GW, "Application of multiattribute utility theory to measure social preferences for health states", Oper Res, 30, pp.1043~1069 (1982)
- Torrance GW, "Multiattribute utility function for a comprehensive health status classification system: Health Utilities Index Mark 2", Med Care, 34, pp.702~722 (1996)
- "EuroQol: a new facility for the measurement of health-related quality of life. EuroQol Group", Health Policy, 16, pp.199~208 (1990)
- Brooks R, "EuroQol: the current state of play", Health Policy, 37, pp.53~72 (1996)
- Brooks R, "The Measurement and valuation of health status using EQ-5D: A European perspective. Dordrecht" (2003), Kluwer academic publisher
- Jo MW, "Estimating Quality Weights for EQ-5D Health States with the Time Trade-Off Method in South Korea", Value Health (In press)
- 강은정, "EQ-5D를 이용한 건강수준의 가치 평가", 보건경제와 정책연구, 12(2), pp.19~43 (2006), 한국보건경제정책학회
- Post PN, "The utility of health states after stroke: a systematic review of the literatuve", Stroke, 32, pp.1425~1429 (2001)
- Pickard AS, "Responsiveness of generic health-related quality of life measures in stroke", Qual Life Res, 14, pp.207~219 (2005)
- 유경호, "한국 뇌졸중 자료은행에 등록된 10,811명의 급성기 허혈성 뇌졸중 환자 분석: 병원기반 다의료기관 전향적 자료등록 연구", 대한신경과학회지, 24(6), pp.535~543 (2006), 대한신경과학회
- Di Carlo A, "Sex differences in the clinical presentation, resource use, and 3-month outcome of acute stroke in Europe: data from a multicenter multinational hospital-based registry", Stroke, 34, pp.1114~1119 (2003)
- Kapral MK, "Sex differences in stroke care and outcomes: results from the Registry of the Canadian Stroke Network", Stroke, 36, pp.809~814 (2005)
- Patel MD, "Clinical determinants of long-term quality of life after stroke", Age Ageing, 36, pp.316~322 (2007)
- Carod-Artal J, "Quality of life among stroke survivors evaluated 1 year after stroke: experience of a stroke unit", Stroke, 31, pp.2995~3000 (2000)
- Xie J, "Impact of stroke on health-related quality of life in the noninstitutionalized population in the United States", Stroke, 37, pp.2567~2572 (2006)
- Niemi M, "Quality of life 4 years after stroke", Stroke, 19, pp.1101~1107 (1988)
- Sturm JW, "Quality of life after stroke: the North East Melbourne Stroke Incidence Study (NEMESIS)", Stroke, 35, pp.2340~2345 (2004)
- de Haan R, "Quality of life after stroke. Impact of stroke type and lesion location", Stroke, 26, pp.402~408 (1995)
- Fischer U, "Quality of life in stroke survivors after local intra-arterial thrombolysis", Cerebrovasc Dis, 25, pp.438~444 (2008)
- van Exel NJ, "Assessment of post-stroke quality of life in cost-effectiveness studies: the usefulness of the Barthel Index and the EuroQoL-5D", Qual Life Res, 13, pp.427~433 (2004)
- Dorman PJ, "Is the EuroQol a valid measure of health-related quality of life after stroke?", Stroke, 28, pp.1876~1882 (1997)