Functional outcomes and expectation of patients on their functional outcomes after acute stroke
Keywords:
Functional outcomes, Patient with acute stroke, ExpectationAbstract
Stroke is the leading cause of death and a major cause of disability worldwide. This descriptive study aimed to 1) study functional outcomes among patients with acute stroke, 2) study the expectation of patients on their functional outcomes after acute stroke. The subjects were 155 patients with acute stroke who were admitted to a tertiary hospital in Bangkok. Purposive sampling was applied to recruit patients with acute stroke listed in the hospital admission system and inclusion criteria. Research instruments consisted of questionnaires for general characteristics, health information, National Institutes of Health Stroke Scale (NHISS), modified Rankin Scale (mRS), Barthel index (BI), EQ-5D-5L, and the question of expectations of patients on their functional outcomes after acute stroke. Data were analyzed using descriptive statistics and inferential statistics. The results showed that most of the samples were male (62.6%). The average age was 64 years (S.D.=12.5). Most of the samples were patients with acute ischemic stroke (89.6%). Functional outcomes at discharge showed that the mean NIHSS was 4 scores, the mean mRS was 3, the mean BI was 70.4, and the utility scores was 0.7. Patients with intracerebral hemorrhage had significantly poorer functional outcomes than those with ischemic stroke (p<.05). Expectations of patients on their functional outcomes after acute stroke were worse than expected (13.5%), as reasonable as expected (49.0%), and better than expected (37.5%). After the stroke, patients with different expectations of their functional outcomes had significantly different functional outcomes in all indices
References
Bhalla, A., Wang, Y., Rudd, A., & Wolfe, C. D. (2013).
Differences in outcome and predictors between
ischemic and intracerebral hemorrhage: the South
London Stroke Register. Stroke, 44(8), 2174-2181.
doi:10.1161/strokeaha.113.001263
Bindawas, S. M., Vennu, V., Mawajdeh, H., & Alhaidary,
H. (2017). Functional outcomes by age after
inpatient stroke rehabilitation in Saudi Arabia.
Clin Interv Aging, 12, 1791-1797. doi:10.2147/
cia.S145402
Broderick, J. P., Adeoye, O., & Elm, J. (2017). Evolution
of the Modified Rankin Scale and Its Use in Future
Stroke Trials. Stroke, 48(7), 2007-2012. doi:
1161/strokeaha.117.017866
Buapang, S., & Putkanin, N. (2017). Quality of life of early
age patients with stroke at outpatient department,
Srinakarin hospital. North-Eastern Thai Journal
of Neuroscience, 11(4), 61-75.
Butsing, N. (2017). Quality-adjusted survival (QAS) among
patients with ischemic stroke and intracerebral
hemorrhage [Doctoral dissertation]: Mahidol
University.118
Butsing, N., Tipayamongkholgul, M., & Ratanakorn, D.
(2019). Estimation of expected years of life lost for
patients with ischemic stroke and intracerebral
hemorrhage. Journal of Health Research, 33(5),
-415. doi:10.1108/JHR-10-2018-0126
Butsing, N., Tipayamongkholgul, M., Ratanakorn, D.,
Suwannapong, N., & Bundhamcharoen, K. (2019).
Social support, functional outcome and quality of
life among stroke survivors in an urban area.Journal
of Pacific Rim Psychology, 13, e4. doi:10.1017/
prp.2019.2
Chaleoykitti, S., Srithumsuk, W., Jaipong, S., Pattayakorn,
P., Pattayakorn, P., & Podimuang, K. (2020).
Association between Clinical Characteristics and
Quality of Life in Older People with Stroke at
Hospital Discharge. Advances in Aging Research,
(4), 67-76. doi:10.4236/aar.2020.94006
Chiu, D., Peterson, L., Elkind, M. S. V., Rosand, J.,
Gerber, L. M., & Silverstein, M. D. (2010).
Comparison of outcomes after intracerebral
hemorrhage and ischemic stroke. Journal of Stroke
& Cerebrovascular Diseases, 19(3), 225-229.
doi:10.1016/j.jstrokecerebrovasdis.2009.06.002
Chou, C. Y. (2015). Determinants of the health-related
quality of life for stroke survivors. Journal of Stroke
& Cerebrovascular Diseases, 24(3), 655-662.
doi:10.1016/j.jstrokecerebrovasdis.2014.10.022
Davis, S., Lees, K., & Donnan, G. (2006). Treating the
acute stroke patient as an emergency: current
practices and future opportunities. International
journal of clinical practice, 60(4), 399-407.
doi:10.1111/j.1368-5031.2006.00873.x
Faul, F., Erdfelder, E., Lang, A.-G., & Buchner, A. (2007).
G*Power 3: A flexible statistical power analysis
program for the social, behavioral, and biomedical
sciences. Behavior Research Methods, 39(2),
-191. doi:10.3758/BF03193146
Feigin, V. L., Norrving, B., & Mensah, G. A. (2017).
Global Burden of Stroke.Circulation Research,
(3), 439-448. doi:10.1161/CIRCRESAHA.
308413
Hemphill, J. C., Greenberg, S. M., Anderson, C. S., Becker,
K., Bendok, B. R., Cushman, M., . . . Woo, D.
(2015). Guidelines for the Management of
Spontaneous Intracerebral Hemorrhage.Stroke,
(7), 2032-2060. doi:10.1161/STR.000000000000
Hinkle, J. L. (2014). Reliability and Validity of the National
Institutes of Health Stroke Scale for Neuroscience
Nurses. Stroke, 45(3), e32-e34. doi:10.1161/
STROKEAHA.113.004243
International Health Policy Program Foundation. (2017).
Burden of Disease Thailand 2014. Retrieved
from Nonthaburi: The Graphigo Systems.
Katan, M., & Luft, A. (2018). Global Burden of Stroke.
Seminars Neurology, 38(2), 208-211. doi:10.1055/
s-0038-1649503
Kleindorfer, D. O., Towfighi, A., Chaturvedi, S., Cockroft,
K. M., Gutierrez, J., Lombardi-Hill, D., . . .
Williams, L. S. (2021). 2021 Guideline for the
Prevention of Stroke in Patients With Stroke and
Transient Ischemic Attack: A Guideline From the
American Heart Association/American Stroke
Association.Stroke, 52(7), e364-e467. doi:10.1161/
STR.0000000000000375
Mahoney, F. I., & Barthel, D. W. (1965). FUNCTIONAL
EVALUATION: THE BARTHEL INDEX.
Maryland State Medical Journal, 14, 61-65.
Ortiz, G. A., & L. Sacco, R. (2014). National Institutes
of Health Stroke Scale (NIHSS). In Wiley Stats
Ref: Statistics Reference Online.
Panthong, P., & Phatisena, T. (2018). The empowerment
of caregivers for rehabilitation of stroke patients
at Maharat Nakhon Ratchasima Hospital. Journal
of the Office of DPC 9, 24(2), 57- 66.
Pattanaphesaj, J. (2014). Health-related quality of life
measure (EQ-5D-5L): measurement property
testing and its preferencebased score in Thai
population [Doctoral dissertation]: Mahidol
University.
Powers, W. J., Rabinstein, A. A., Ackerson, T., Adeoye,
O. M., Bambakidis, N. C., Becker, K., . . .
Tirschwell, D. L. (2019). Guidelines for the Early
Management of Patients With Acute Ischemic
Stroke: 2019 Update to the 2018 Guidelines for
the Early Management of Acute Ischemic Stroke:
A Guideline for Healthcare Professionals From
the American Heart Association/American Stroke
Association.Stroke, 50(12), e344-e418. doi:10.
/STR.0000000000000211
Quinn, T. J., Dawson, J., Walters, M. R., & Lees, K. R.
(2009). Reliability of the Modified Rankin
Scale.Stroke, 40(10), 3393-3395. doi:10.1161/
STROKEAHA.109.557256
Rachpukdee, S., Howteerakul, N., Suwannapong, N., &
Tang-Aroonsin, S. (2013). Quality of life of
stroke survivors: a 3-month follow-up study.
Journal of Stroke & Cerebrovascular Diseases,
(7), e70-78. doi:10.1016/j.jstrokecerebrovasdis.
05.005
Rankin, J. (1957). Cerebral vascular accidents in patients
over the age of 60. II. Prognosis. Scottish Medical
Journal, 2(5), 200-215. doi:10.1177/003693305700
Sturm, J. W., Donnan, G. A., Dewey, H. M., Macdonell,
R. A., Gilligan, A. K., Srikanth, V., & Thrift, A. G.
(2004). Quality of life after stroke: the North East
Melbourne Stroke Incidence Study (NEMESIS).
Stroke, 35(10), 2340-2345. doi:10.1161/
STR.0000141977.18520.3b
Suksathien R, & Sukpongthai T. (2017). Predictors of
long-term functional outcomes in acute stroke
patients. Journal of Thai Rehabilitation Medicine,
(3), 96-100. doi:10.14456/jtrm.2017.20
Tadi, P., & Lui, F. (2021). Acute Stroke. [Updated 2021
Mar 24]. In: StatPearls [Internet]. Treasure Island
(FL): StatPearls Publishing. Retrieved from https:/
/www.ncbi.nlm.nih.gov/books/NBK535369/
Wouters, A., Nysten, C., Thijs, V., & Lemmens, R. (2018).
Prediction of Outcome in Patients With Acute
Ischemic Stroke Based on Initial Severity and
Improvement in the First 24 h. Frontiers in
Neurology, 9(308). doi:10.3389/fneur.2018.00308
