Decline in Health-related Quality of Life Among Ischemic Stroke Survivors Discharged from Inpatient Rehabilitation to Home

Research Objectives: This study is to describe changes in Health-Related Quality of Life (HRQoL) among ischemic stroke survivors during the transition from inpatient rehabilitation facilities (IRFs) to home settings within 12 months post-acute stroke.

Design: A Prospective longitudinal study at the University of Utah, USA.

Setting: Inpatient rehabilitation facilities (IRFs) to home settings.

Participants: 38 ischemic stroke survivors (20 males, 18 females; mean age 62 years) who are discharged from an inpatient rehabilitation facility to home.

Interventions: Participants were assessed using the EQ-5D-5L questionnaire at IRF discharge (time 1), 6 months post-acute stroke (time 2), and 12 months post-acute stroke (time 3).

Main Outcome Measures: EQ-5D-5L scores for each dimension, Visual Analog Scale (VAS) for overall health, and a composite health state index were calculated. Notably, lower scores in five dimensions indicated better HRQoL.

Results: In summary, during the transition period, HRQoL initially declined from Time 1 to Time 2 and then improved from Time 2 to Time 3 in the domains of mobility, self-care, pain & discomfort, as well as anxiety & depression. However, HRQoL related to usual activities consistently increased over this period. Furthermore, the VAS Score consistently increased from 59 to 65 to 67, indicating that patients' perception of their health improved over time. Moreover, the health state index initially showed a decline from Time 1 to Time 2 but increased afterward, demonstrating a positive trend in overall HRQoL.

Conclusions: Contrary to our initial expectations, our study revealed a nuanced picture of Health-Related Quality of Life changes post-acute stroke. Patients' perceptions of HRQoL, assessed using the Visual Analog Scale, consistently improved over time. Although the health state index initially declined from Time 1 to Time 2, it later increased. Certain HRQoL dimensions initially decreased but subsequently improved from Time 2 to Time 3. These complex HRQoL patterns during the transition from IRF to home point to the need for further investigation, focusing on factors like depressive symptoms, engagement in activities, individual characteristics, and hospital stay duration, to guide personalized interventions for post-acute stroke recovery.

Author(s) Disclosures: No conflicts of interest or financial disclosures relevant to this study were declared.