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| DOI | 10.3389/FNEUR.2025.1539107 | ||||
| Año | 2025 | ||||
| Tipo | artículo de investigación |
Citas Totales
Autores Afiliación Chile
Instituciones Chile
% Participación
Internacional
Autores
Afiliación Extranjera
Instituciones
Extranjeras
Background and aims: The transformation of modified Rankin Scale (mRS) scores based on the corresponding utilities of health-related quality of life questionnaires can facilitate the capture of Patient-Centered Outcomes (PCO) in stroke. We aimed to derive utility-weighted modified Rankin Scale (UW-mRS) values by mapping mRS functional status to EQ-5D-3L scores in a population-based cohort of stroke patients. Methods: The UW-mRS was obtained by analyzing the EQ5-D-3 L and mRS scores at 180 days after any stroke in the NANDU study, a large prospective community-based study in Chile. The mRS prediction was estimated using a linear regression adjusted by the EQ-5D-3L value. Generalized linear and binary logistic regression models were constructed to determine influencing factors of the UW-mRS, using STATA software (version 18.0). Results: We included 773 patients presenting with any stroke during 2015-2016: 48% were female, with a mean age of 71 years (SD 13.8), and 85% had an acute ischemic stroke (AIS). 82% of patients had a low socioeconomic status, 50% had less than 12 years of formal education, and only 32% lived in urban areas. UW-mRS values for mRS categories 0-6 at 180 days were 0.913, 0.694, 0.425, 0.249, -0.102, -0.347 and 0, respectively. Multivariable analysis identified age > 70 years (Coefficient beta [beta] -0.038 [Standard error SE 0.018], p = 0.032), prior mRS score 3-5 (beta -0.556 [SE 0.197], p < 0.001), ischemic stroke (beta -0.066 [SE 0.025], p = 0.010), and National Institutes of Health Stroke Scale (NIHSS) at admission>5 (beta -0.015 [SE 0.002], p < 0.001) as significant predictors of worse UW-mRS scores (R-2 = 70%) in the overall group. Sex-disaggregated analysis showed that age > 70 years was a significant predictor in males (beta -0.069 [SE 0.024], p = 0.006), while presenting an AIS had a greater impact on female's worse UW-mRS score (beta -0.087 [SE 0.033], p = 0.010). Conclusion: These results present UW-mRS values derived from a population-based stroke study. Key determinants of health-related quality of life in post-stroke patients included age, prior disability, and stroke severity. Sex-disaggregated analysis revealed age being significant for males and AIS for females. Incorporating PCO as UW-mRS in stroke research can provide a more nuanced understanding of the impact of stroke on survivors, offering valuable insights for clinical decision-making and rehabilitation strategies across diverse healthcare contexts.
| Ord. | Autor | Género | Institución - País |
|---|---|---|---|
| 1 | Delfino, C. | Hombre |
Universidad del Desarrollo - Chile
Facultad de Medicina Clínica Alemana Universidad del Desarrollo - Chile |
| 2 | Cavada, Gabriel | - |
Universidad del Desarrollo - Chile
Facultad de Medicina Clínica Alemana Universidad del Desarrollo - Chile |
| 3 | HOFFMEISTER-ARCE, LORENA | Mujer |
Universidad del Desarrollo - Chile
Facultad de Medicina Clínica Alemana Universidad del Desarrollo - Chile |
| 4 | Lavados, Pablo | - |
Universidad del Desarrollo - Chile
Facultad de Medicina Clínica Alemana Universidad del Desarrollo - Chile |
| 5 | Venturelli, Paula Munoz | - |
Universidad del Desarrollo - Chile
Univ New South Wales - Australia Facultad de Medicina Clínica Alemana Universidad del Desarrollo - Chile UNSW Medicine - Australia |
| Fuente |
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| Clinica Alemana de Santiago |
| Pfizer |
| ANID Fondecyt |
| Agencia Nacional de Investigación y Desarrollo |
| Agradecimiento |
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| PMV receives research grants from ANID Fondecyt Regular N\u00B0 1221837 and a Research Grant from Pfizer 7688348. PL reports research support from Cl\u00EDnica Alemana and Boehringer Ingelheim. Research grants from Cl\u00EDnica Alemana de Santiago during the conduct of the study, personal fees from Boehringer Ingelheim, and a Chilean Government research grant (ANID) for the \u00D1ANDU project. |