Estimates of outcomes up to ten years after stroke: analysis from the prospective South London Stroke Register.

<h4>Background</h4>Although stroke is acknowledged as a long-term condition, population estimates of outcomes longer term are lacking. Such estimates would be useful for planning health services and developing research that might ultimately improve outcomes. This burden of disease study...

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Autores principales:	Charles D A Wolfe, Siobhan L Crichton, Peter U Heuschmann, Christopher J McKevitt, André M Toschke, Andy P Grieve, Anthony G Rudd
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2011
Materias:	Medicine R
Acceso en línea:	https://doaj.org/article/0c5dc03a6496421aa41a06d36b739140
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spelling	oai:doaj.org-article:0c5dc03a6496421aa41a06d36b7391402021-11-18T05:41:49ZEstimates of outcomes up to ten years after stroke: analysis from the prospective South London Stroke Register.1549-12771549-167610.1371/journal.pmed.1001033https://doaj.org/article/0c5dc03a6496421aa41a06d36b7391402011-05-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/21610863/?tool=EBIhttps://doaj.org/toc/1549-1277https://doaj.org/toc/1549-1676<h4>Background</h4>Although stroke is acknowledged as a long-term condition, population estimates of outcomes longer term are lacking. Such estimates would be useful for planning health services and developing research that might ultimately improve outcomes. This burden of disease study provides population-based estimates of outcomes with a focus on disability, cognition, and psychological outcomes up to 10 y after initial stroke event in a multi-ethnic European population.<h4>Methods and findings</h4>Data were collected from the population-based South London Stroke Register, a prospective population-based register documenting all first in a lifetime strokes since 1 January 1995 in a multi-ethnic inner city population. The outcomes assessed are reported as estimates of need and included disability (Barthel Index <15), inactivity (Frenchay Activities Index <15), cognitive impairment (Abbreviated Mental Test < 8 or Mini-Mental State Exam <24), anxiety and depression (Hospital Anxiety and Depression Scale >10), and mental and physical domain scores of the Medical Outcomes Study 12-item short form (SF-12) health survey. Estimates were stratified by age, gender, and ethnicity, and age-adjusted using the standard European population. Plots of outcome estimates over time were constructed to examine temporal trends and sociodemographic differences. Between 1995 and 2006, 3,373 first-ever strokes were registered: 20%-30% of survivors had a poor outcome over 10 y of follow-up. The highest rate of disability was observed 7 d after stroke and remained at around 110 per 1,000 stroke survivors from 3 mo to 10 y. Rates of inactivity and cognitive impairment both declined up to 1 y (280/1,000 and 180/1,000 survivors, respectively); thereafter rates of inactivity remained stable till year eight, then increased, whereas rates of cognitive impairment fluctuated till year eight, then increased. Anxiety and depression showed some fluctuation over time, with a rate of 350 and 310 per 1,000 stroke survivors, respectively. SF-12 scores showed little variation from 3 mo to 10 y after stroke. Inactivity was higher in males at all time points, and in white compared to black stroke survivors, although black survivors reported better outcomes in the SF-12 physical domain. No other major differences were observed by gender or ethnicity. Increased age was associated with higher rates of disability, inactivity, and cognitive impairment.<h4>Conclusions</h4>Between 20% and 30% of stroke survivors have a poor range of outcomes up to 10 y after stroke. Such epidemiological data demonstrate the sociodemographic groups that are most affected longer term and should be used to develop longer term management strategies that reduce the significant poor outcomes of this group, for whom effective interventions are currently elusive. Please see later in the article for the Editors' Summary.Charles D A WolfeSiobhan L CrichtonPeter U HeuschmannChristopher J McKevittAndré M ToschkeAndy P GrieveAnthony G RuddPublic Library of Science (PLoS)articleMedicineRENPLoS Medicine, Vol 8, Iss 5, p e1001033 (2011)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R
spellingShingle	Medicine R Charles D A Wolfe Siobhan L Crichton Peter U Heuschmann Christopher J McKevitt André M Toschke Andy P Grieve Anthony G Rudd Estimates of outcomes up to ten years after stroke: analysis from the prospective South London Stroke Register.
description	<h4>Background</h4>Although stroke is acknowledged as a long-term condition, population estimates of outcomes longer term are lacking. Such estimates would be useful for planning health services and developing research that might ultimately improve outcomes. This burden of disease study provides population-based estimates of outcomes with a focus on disability, cognition, and psychological outcomes up to 10 y after initial stroke event in a multi-ethnic European population.<h4>Methods and findings</h4>Data were collected from the population-based South London Stroke Register, a prospective population-based register documenting all first in a lifetime strokes since 1 January 1995 in a multi-ethnic inner city population. The outcomes assessed are reported as estimates of need and included disability (Barthel Index <15), inactivity (Frenchay Activities Index <15), cognitive impairment (Abbreviated Mental Test < 8 or Mini-Mental State Exam <24), anxiety and depression (Hospital Anxiety and Depression Scale >10), and mental and physical domain scores of the Medical Outcomes Study 12-item short form (SF-12) health survey. Estimates were stratified by age, gender, and ethnicity, and age-adjusted using the standard European population. Plots of outcome estimates over time were constructed to examine temporal trends and sociodemographic differences. Between 1995 and 2006, 3,373 first-ever strokes were registered: 20%-30% of survivors had a poor outcome over 10 y of follow-up. The highest rate of disability was observed 7 d after stroke and remained at around 110 per 1,000 stroke survivors from 3 mo to 10 y. Rates of inactivity and cognitive impairment both declined up to 1 y (280/1,000 and 180/1,000 survivors, respectively); thereafter rates of inactivity remained stable till year eight, then increased, whereas rates of cognitive impairment fluctuated till year eight, then increased. Anxiety and depression showed some fluctuation over time, with a rate of 350 and 310 per 1,000 stroke survivors, respectively. SF-12 scores showed little variation from 3 mo to 10 y after stroke. Inactivity was higher in males at all time points, and in white compared to black stroke survivors, although black survivors reported better outcomes in the SF-12 physical domain. No other major differences were observed by gender or ethnicity. Increased age was associated with higher rates of disability, inactivity, and cognitive impairment.<h4>Conclusions</h4>Between 20% and 30% of stroke survivors have a poor range of outcomes up to 10 y after stroke. Such epidemiological data demonstrate the sociodemographic groups that are most affected longer term and should be used to develop longer term management strategies that reduce the significant poor outcomes of this group, for whom effective interventions are currently elusive. Please see later in the article for the Editors' Summary.
format	article
author	Charles D A Wolfe Siobhan L Crichton Peter U Heuschmann Christopher J McKevitt André M Toschke Andy P Grieve Anthony G Rudd
author_facet	Charles D A Wolfe Siobhan L Crichton Peter U Heuschmann Christopher J McKevitt André M Toschke Andy P Grieve Anthony G Rudd
author_sort	Charles D A Wolfe
title	Estimates of outcomes up to ten years after stroke: analysis from the prospective South London Stroke Register.
title_short	Estimates of outcomes up to ten years after stroke: analysis from the prospective South London Stroke Register.
title_full	Estimates of outcomes up to ten years after stroke: analysis from the prospective South London Stroke Register.
title_fullStr	Estimates of outcomes up to ten years after stroke: analysis from the prospective South London Stroke Register.
title_full_unstemmed	Estimates of outcomes up to ten years after stroke: analysis from the prospective South London Stroke Register.
title_sort	estimates of outcomes up to ten years after stroke: analysis from the prospective south london stroke register.
publisher	Public Library of Science (PLoS)
publishDate	2011
url	https://doaj.org/article/0c5dc03a6496421aa41a06d36b739140
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Estimates of outcomes up to ten years after stroke: analysis from the prospective South London Stroke Register.

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