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[article] | Titre : |
Differential Effects of Time to Initiation of Therapy on Disability and Quality of Life in Patients With Mild and Moderate to Severe Ischemic Stroke |
| Type de document : |
Périodique |
| Auteurs : |
Robert L. Askew ; Carmen E. Capo-Lugo ; Andrew Naidech ; Shyam K. Prabhakaran |
| Année de publication : |
2020 |
| Article en page(s) : |
p. 1515-1522 |
| Note générale : |
https://doi.org/10.1016/j.apmr.2020.05.005 |
| Langues : |
Anglais (eng) |
| Descripteurs : |
HE Vinci
Abdomen aigu ; Accident vasculaire cérébral (AVC) ; Évaluation des résultats et des processus en soins de santé ; Mesures des résultats rapportés par les patients (PROM) ; Qualité des soins de santé ; Réadaptation ; Rééducation neurologique ; Services de santé
|
| Résumé : |
Objective
To assess the effect of time to acute therapy on health-related quality of life (HRQoL) and disability after ischemic stroke.
Design
Prospective cohort study.
Setting
Comprehensive stroke care center in a large metropolitan city.
Participants
Patients (N=553; mean age, 67 y; 51.9% male; 64.4% white; 88.8% ischemic stroke) with ischemic stroke or transient ischemic attack (TIA) enrolled in a longitudinal observational study between August 2012 to January 2014 who received rehabilitation services.
Intervention
Not applicable.
Main Outcome Measures
Disability status was assessed with the modified Rankin Scale (mRS) and Barthel Index (BI). HRQoL was assessed using the Quality of Life in Neurological Disorders measures of executive function, general cognitive concerns, upper extremity dexterity, and lower extremity mobility. Time to therapy consult and treatment were defined as the number of days from hospital admission to initial consult by a therapist and number of days from hospital admission to initial treatment, respectively.
Results
Among the participants, the median number of days from hospital admission to acute therapy consult was 2 days (interquartile range, 1-3d). Multivariable linear and logistic regression models indicated that for those with the National Institutes of Health Stroke Scale (NIHSS) score
Conclusions
Longer time to initiation of acute therapy has differential effects on poststroke disability and HRQoL up to 1-month after ischemic stroke and TIA. The effect of acute therapy consult is more notable for those with mild deficits, while the effect of acute therapy treatment is more notable for those with moderate to severe deficits. Minimizing time to therapy consults and treatments in the acute hospital period might improve outcomes after ischemic stroke and TIA. |
| Disponible en ligne : |
Oui |
| En ligne : |
https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] |
| Permalink : |
https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=259805 |
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 9 (2020) . - p. 1515-1522
[article] Differential Effects of Time to Initiation of Therapy on Disability and Quality of Life in Patients With Mild and Moderate to Severe Ischemic Stroke [Périodique] / Robert L. Askew ; Carmen E. Capo-Lugo ; Andrew Naidech ; Shyam K. Prabhakaran . - 2020 . - p. 1515-1522. https://doi.org/10.1016/j.apmr.2020.05.005 Langues : Anglais ( eng) in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 9 (2020) . - p. 1515-1522 | Descripteurs : |
HE Vinci
Abdomen aigu ; Accident vasculaire cérébral (AVC) ; Évaluation des résultats et des processus en soins de santé ; Mesures des résultats rapportés par les patients (PROM) ; Qualité des soins de santé ; Réadaptation ; Rééducation neurologique ; Services de santé
|
| Résumé : |
Objective
To assess the effect of time to acute therapy on health-related quality of life (HRQoL) and disability after ischemic stroke.
Design
Prospective cohort study.
Setting
Comprehensive stroke care center in a large metropolitan city.
Participants
Patients (N=553; mean age, 67 y; 51.9% male; 64.4% white; 88.8% ischemic stroke) with ischemic stroke or transient ischemic attack (TIA) enrolled in a longitudinal observational study between August 2012 to January 2014 who received rehabilitation services.
Intervention
Not applicable.
Main Outcome Measures
Disability status was assessed with the modified Rankin Scale (mRS) and Barthel Index (BI). HRQoL was assessed using the Quality of Life in Neurological Disorders measures of executive function, general cognitive concerns, upper extremity dexterity, and lower extremity mobility. Time to therapy consult and treatment were defined as the number of days from hospital admission to initial consult by a therapist and number of days from hospital admission to initial treatment, respectively.
Results
Among the participants, the median number of days from hospital admission to acute therapy consult was 2 days (interquartile range, 1-3d). Multivariable linear and logistic regression models indicated that for those with the National Institutes of Health Stroke Scale (NIHSS) score
Conclusions
Longer time to initiation of acute therapy has differential effects on poststroke disability and HRQoL up to 1-month after ischemic stroke and TIA. The effect of acute therapy consult is more notable for those with mild deficits, while the effect of acute therapy treatment is more notable for those with moderate to severe deficits. Minimizing time to therapy consults and treatments in the acute hospital period might improve outcomes after ischemic stroke and TIA. |
| Disponible en ligne : |
Oui |
| En ligne : |
https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] |
| Permalink : |
https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=259805 |
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