Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/23070
Title: Pre-existing Comorbidity Burden and Patient Perceived Stroke Impact.
Authors: Sewell, Katherine;Tse, Tamara;Harris, Elizabeth;Matyas, Thomas;Churilov, Leonid;Ma, Henry;Davis, Stephen M;Donnan, Geoffrey A;Carey, Leeanne M
Affiliation: Department of Occupational Therapy, St Vincent's Hospital, Fitzroy, Australia
Department of Neurology, Royal Melbourne Hospital, University of Melbourne, Parkville, Australia
Faculty of Medicine and Health Sciences, Melbourne Medical School, University of Melbourne, Parkville, Australia
Department of Medicine, Monash Health, Monash University, Clayton, Australia
Department of Occupational Therapy, Social Work and Social Policy, School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia
Neurorehabilitation and Recovery, Stroke Division, The Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria, Australia
Melbourne Brain Centre, Royal Melbourne Hospital, University of Melbourne, Parkville, Australia
Austin Health, Heidelberg, Victoria, Australia
Issue Date: 23-Apr-2020
EDate: 2020-04-23
Citation: International journal of stroke : official journal of the International Stroke Society 2020: online first: 23 April
Abstract: Pre-existing comorbidities can compromise recovery post-stroke. However, the association between comorbidity burden and patient-rated perceived impact has not been systematically investigated. To date, only observer-rated outcome measures of function, disability, and dependence have been used, despite the complexity of the impact of stroke on an individual. Our aim was to explore the association between comorbidity burden and patient-rated perceived impact and overall recovery, within the first-year post-stroke, after adjusting for stroke severity, age, and sex. The sample comprised 177 stroke survivors from 18 hospitals throughout Australia and New Zealand. Comorbidity burden was calculated using the Charlson Comorbidity Index. Perceived impact and recovery were measured by the Stroke Impact Scale index and Stroke Impact Scale overall recovery scale. Quantile regression models were applied to investigate the association between comorbidity burden and perceived impact and recovery. Significant negative associations between the Charlson Comorbidity Index and the Stroke Impact Scale index were found at three months. At the .25 quantile, a one-point increase on the Charlson Comorbidity Index was associated with 6.80-points decrease on the Stroke Impact Scale index (95%CI: -11.26, -2.34; p = .003). At the median and .75 quantile, a one-point increase on the Charlson Comorbidity Index was associated, respectively, with 3.58-points decrease (95%CI: -5.62, -1.54; p = .001) and 1.76-points decrease (95%CI: -2.80, -0.73; p = .001) on the Stroke Impact Scale index. At 12 months, at the .25 and .75 quantiles, a one-point increase on the Charlson Comorbidity Index was associated, respectively, with 6.47-points decrease (95%CI: -11.05, -1.89; p = .006) and 1.26-points decrease (95%CI: -2.11, -0.42; p = .004) on the Stroke Impact Scale index. For the Stroke Impact Scale overall recovery measure, significant negative associations were found only at the median at three months and at the .75 quantile at 12 months. Comorbidity burden is independently associated with patient-rated perceived impact within the first-year post-stroke. The addition of patient-rated impact measures in personalized rehabilitation may enhance the use of conventional observer-rated outcome measures.
URI: http://ahro.austin.org.au/austinjspui/handle/1/23070
DOI: 10.1177/1747493020920838
ORCID: 0000-0001-6376-8613
0000-0002-7136-5037
0000-0002-9807-6606
0000-0001-6324-3403
PubMed URL: 32326843
Type: Journal Article
Subjects: Comorbidity
comorbidity burden
patient reported outcome measures
stroke recovery stroke impact and perceived recovery
Appears in Collections:Journal articles

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