Long-term outcome after reperfusion-treated stroke
Oscar Mühr, Hanna C. Persson, Katharina S. Sunnerhagen
Department of Clinical Neuroscience and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg , SE-41345 Gothenburg, Sweden. E-mail: firstname.lastname@example.org
Objective: To explore motor function, health-related quality of life and impact on activities of daily living 5 and 6 years after reperfusion treatment in patients with stroke.
Methods: A total of 75 patients with first-time stroke received either thrombectomy or thrombolytic treatment at the Sahlgrenska University Hospital in Gothenburg during an 18-month period in 2009-2010. Follow-up involved questionnaires and clinical examinations, 5 and 6 years post-stroke. The results were compared with an individually matched reference group.
Results: At follow-up 54 persons with reperfusion-treated stroke were alive, of whom 31 (57%) answered the questionnaires and 16 agreed to a clinical examination. The Stroke Impact Scale showed impact in several areas, with the emotion domain being the most affected. The reperfusion-treated group reported significantly better strength and hand function compared with the reference group. Of those clinically examined, 44% were dependent in activities of daily living and 38% had cognitive impairment.
Conclusion: Long-term outcome after reperfusion treatment is relatively good, with treated individuals having better strength and hand function compared with a reference group. However, emotional and cognitive problems persist and need to be addressed.
What is the long-term situation for patients treated with thrombolysis or thrombectomy for their stroke?
New methods to restore circulation in the brain after an infarct caused by a clot has been developed. To dissolve the clot (thrombolysis) or retract it (thrombectomy) has shown to reduce the consequences of stroke severity acutely and to save lives. However, the long-term effects have not been explored. 75 patients with a first occurrence of stroke had received this treatment during 2009 and 2010. At 5 years, there were still 54 persons alive, of whom 31 answered a questionnaire 5 years and 16 agreed to a clinical examination (at 6 years). There were compared with stroke patients who were admitted to the same hospital during the same period with similar stroke severity but who did not received treatment that dissolved the clot. Those that had received treatment reported better strength and hand function than the control group. Most were independent in ADL but still almost 4 of 10 had cognitive problems. The long-term outcome is good but the remaining cognitive problems need to be addressed.
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