Patient-reported health-related quality of life after stroke thrombectomy in clinical practice.

Deb-Chatterji, Milani; Konnopka, Alexander; Flottmann, Fabian; Leischner, Hannes; Fiehler, Jens; Gerloff, Christian; Thomalla, Götz

OBJECTIVE To determine patient-reported health-related quality of life (HRQoL) after stroke thrombectomy in clinical practice, and to identify predictors of better HRQoL, we analyzed data of 504 consecutive patients treated in a large university stroke center. METHODS All stroke patients treated by thrombectomy (June 2015-October 2018) were prospectively enrolled in this observational study. At 90 days, functional outcome was assessed by the mRS, and patient-reported HRQoL by the EuroQol Group 5 Dimension (EQ-5D) Self-report Questionnaire, consisting of five health domains. The EQ-5D utility index (EQ-5D-I; -0.594 to 1.00 with higher values indicating better HRQoL) was calculated. Linear regression analysis was applied to identify predictors of better HRQoL (higher EQ-5D-I). RESULTS Of 504 patients (median age 76 years, 51.8% female), the mean EQ-5D-I was 0.39 (SD 0.44). The proportion of stroke survivors who reported complaints in the different domains decreased from 66% in Usual Activities, to 57% in Mobility, 50.4% in Selfcare, 41.7% in Pain/Discomfort and 40.8% Anxiety/Depression. A lower age, a lower pre-stroke mRS, a lower baseline NIHSS, and a higher ASPECT score, concomitant thrombolysis therapy, and a successful recanalization were independent predictors of better HRQoL. CONCLUSIONS Patient-reported HRQoL provides a more comprehensive assessment of stroke outcome than the mRS. Health domains involving motor function showed most frequently complaints in HRQoL after stroke thrombectomy, while a large proportion of patients did not report any complaints across the different health domains. Predictors of better HRQoL closely match the predictors of better functional outcome measured by the mRS in other thrombectomy studies.