Functional Impairment Three Months After Acute Stroke: Patient Reported Outcomes in the National Acute Stroke Israeli Registry - Nasis 2016
Miaary, Z.; Tanne, D.; Koton, S.
Harefuah 158(6): 367-371
2019
ISSN/ISBN: 0017-7768 PMID: 31215188 Document Number: 697959
Stroke is a leading cause of mortality, disability and functional impairment. We present clinical and patient-reported outcomes 3-months after stroke in patients from the National Acute Stroke Israeli registry (NASIS) 2016. The NASIS registry includes all patients with acute cerebrovascular events admitted during 2-month periods every 3-years, at all hospitals and departments admitting acute stroke patients in Israel. The current work presents findings on 710 survivors after ischemic stroke or intracerebral hemorrhage (ICH) in NASIS 2016. Outcomes at 3-months were assessed using the modified Rankin Scale (mRS), questions about dysfunction and patient-reported outcomes assessed with the PROMIS 10 scale. Seven-hundred and ten patients were included, 696 (94.2%) with ischemic stroke and 41 (5.8%) with ICH. Mean age of participants was 70.2 years, 58% men. At 3-months, mRS scores were 0-1 for 43% of the patients, 2-3 for 29% and 4-5 for 28%. Functional impairment was more severe in patients with ICH than in ischemic stroke patients. Patients who were discharged from the hospital with functional impairment (mRS≥2) exhibited lower PROMIS 10 scores at 3-months compared to patients with no functional impairment at discharge. This finding was statistically significant in all the PROMIS 10 items, except for fatigue (p=0.874) and pain level (p=0.188). More than half of the patients needed help with their daily functioning 3-months after stroke. Most stroke survivors with functional impairment at discharge reported poor patient-reported outcomes. Post-stroke rehabilitation programs should aim at improving outcomes that are valuable to patients.