Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/21583
Title: Sex Differences in Long-Term Quality of Life Among Survivors After Stroke in the INSTRUCT.
Authors: Phan, Hoang T;Blizzard, Christopher L;Reeves, Mathew J;Thrift, Amanda G;Cadilhac, Dominique A;Sturm, Jonathan;Heeley, Emma;Otahal, Petr;Rothwell, Peter;Anderson, Craig S;Parmar, Priya;Krishnamurthi, Rita;Barker-Collo, Suzanne;Feigin, Valery;Gall, Seana
Affiliation: Menzies Institute for Medical Research Tasmania, University of Tasmania, Hobart, Australia
Department of Epidemiology and Biostatistics, Michigan State University, East Lansing
Department of Health Management and Health Economics, Pham Ngoc Thach University of Medicine, HoChiMinh City, Vietnam
Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Victoria, Australia
The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Heidelberg, Victoria, Australia
George Institute for Global Health, University of Sydney, NSW, Australia
Faculty of Health and Medicine, University of Newcastle, NSW, Australia
Stroke Prevention Research Unit, Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, United Kingdom
Faculty of Health and Medicine, University of Newcastle, NSW, Australia
National Institute for Stroke and Applied Neurosciences, School of Public Health and Psychosocial Studies, Auckland University of Technology, New Zealand
School of Psychology, University of Auckland, New Zealand
National Institute for Stroke and Applied Neurosciences, School of Public Health and Psychosocial Studies, Auckland University of Technology, New Zealand
Issue Date: 15-Aug-2019
EDate: 2019-08-15
Citation: Stroke 2019: STROKEAHA118024437
Abstract: Background and Purpose- Women are reported to have poorer health-related quality of life (HRQoL) after stroke than men, but the underlying reasons are uncertain. We investigated factors contributing to the sex differences. Methods- Individual participant data on 4288 first-ever strokes (1996-2013) were obtained from 4 high-quality population-based incidence studies from Australasia and Europe. HRQoL utility scores among survivors after stroke (range from negative scores=worse than death to 1=perfect health) were calculated from 3 scales including European Quality of Life-5 Dimensions, Short-Form 6-Dimension, and Assessment of Quality of Life at 1 year (3 studies; n=1210) and 5 years (3 studies; n=1057). Quantile regression was used to estimate the median differences in HRQoL for women compared to men with adjustment for covariates. Study factors included sociodemographics, prestroke dependency, stroke-related factors (eg, stroke severity), comorbidities, and poststroke depression. Study-specific median differences were combined into pooled estimates using random-effect meta-analysis. Results- Women had lower pooled HRQoL than men (median differenceunadjusted 1 year, -0.147; 95% CI, -0.258 to -0.036; 5 years, -0.090; 95% CI, -0.119 to -0.062). After adjustment for age, stroke severity, prestroke dependency, and depression, these pooled median differences were attenuated, more greatly at 1 year (-0.067; 95% CI, -0.111 to -0.022) than at 5 years (-0.085; 95% CI, -0.135 to -0.034). Conclusions- Women consistently exhibited poorer HRQoL after stroke than men. This was partly attributable to women's advanced age, more severe strokes, prestroke dependency, and poststroke depression, suggesting targets to reduce the differences. There was some evidence of residual differences in HRQoL between sexes but they were small and unlikely to be clinically significant.
URI: http://ahro.austin.org.au/austinjspui/handle/1/21583
DOI: 10.1161/STROKEAHA.118.024437
ORCID: 0000-0001-8162-682X
PubMed URL: 31412754
Type: Journal Article
Subjects: comorbidity
depression
incidence
quality of life
survivors
Appears in Collections:Journal articles

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