Deans' stroke musings: Prevalence, patterns, and predictors of patient-reported non-motor outcomes at 30 days after acute stroke: prospective observational hospital cohort study

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Friday, December 1, 2023

Prevalence, patterns, and predictors of patient-reported non-motor outcomes at 30 days after acute stroke: prospective observational hospital cohort study

Predicting failure to recover DOES NOTHING for survivors. I'd have you all fired.

Prevalence, patterns, and predictors of patient-reported non-motor outcomes at 30 days after acute stroke: prospective observational hospital cohort study

Hatice Ozkan https://orcid.org/0000-0003-1656-4559, Gareth Ambler, and David Werring https://orcid.org/0000-0003-2074-1861 d.werring@ucl.ac.ukView all authors and affiliations

Accepted Manuscripts

https://doi.org/10.1177/17474930231215660

Abstract

Background

Adverse non-motor outcomes are common after acute stroke and likely to substantially affect quality of life, yet few studies have comprehensively assessed their prevalence, patterns, and predictors across multiple health domains.

Aims

We aim to identify the prevalence, patterns and the factors associated with non-motor outcomes 30 days after stroke.

Methods

This prospective observational hospital cohort study (Stroke Investigation in North and Central London (SIGNAL) identified patients with acute ischaemic stroke or intracerebral haemorrhage (ICH) admitted to the Hyperacute Stroke Unit (HASU) University College Hospital (UCH), London, between August 1st 2018 and August 31st 2019. We assessed non-motor outcomes (anxiety, depression, fatigue, sleep, participation in social roles and activities, pain, bowel, and bladder function) at 30-day follow-up using the Patient Reported Outcome Measurement Information System-Version 29 (PROMIS-29) scale and Barthel Index scale.

Results

We obtained follow-up data for 605/719 (84.1%) eligible patients (mean age 72.0 years; 48.3% female; 521 with ischaemic stroke, 84 with ICH). Anxiety (57.0%), fatigue (52.7%), bladder dysfunction (50.2%), reduced social participation (49.2%), and pain (47.9%) were the commonest adverse non-motor outcomes. The rates of adverse non-motor outcomes in ≥1, ≥2 and ≥3 domains were 89%, 66.3% and 45.8%, respectively; in adjusted analyses, stroke due to ICH (compared to ischaemic stroke) and admission stroke severity were the strongest and most consistent predictors. There were significant correlations between; bowel dysfunction and bladder dysfunction (κ= 0.908); reduced social participation and bladder dysfunction (κ= 0.844); and anxiety and fatigue (κ= 0.613). We did not identify correlation for other pairs of non-motor domains.

Conclusions

Adverse non-motor outcomes are very common at one month after stroke, affecting nearly 90% of evaluated patients in at least one health domain, about two-thirds in two or more domains, and almost 50% in three or more domains. Stroke due to ICH and admission stroke severity were the strongest and most consistent predictors. Adverse outcomes occur in pairs of domains such as with anxiety and fatigue.Our findings emphasise the importance of a multi-domain approach to effectively identify adverse non-motor outcomes after stroke to inform the development of more holistic patient recovery programs.