Infarct location is associated with quality of life after mild ischemic stroke

Abstract

Background

In patients with mild ischemic stroke, small but eloquent infarcts may have devastating effects, particularly on health-related quality of life.

Aim

This study investigates the association between acute infarct location and three-month health-related quality of life in patients with mild ischemic stroke.

Methods

We evaluated consecutively enrolled patients from a single center between August 2012 and July 2013. Our primary outcome at three months was impairment in any health-related quality of life domain (upper extremity, lower extremity, executive function, and general concerns) defined by a T-score <45. We analyzed the association between acute infarct locations and impaired health-related quality of life at three months in univariate and multivariable analysis.

Results

Among 229 patients (mean age 64.9 years, 55% male, 29.7% black, and median initial NIHSS score 1), impaired health-related quality of life was noted in 84 (36.2%) patients at three months. In univariate analysis, patients with subcortical infarcts (56.0% vs. 39.3%, p = 0.02) and brainstem infarcts (21.4% vs. 10.3%, p = 0.02) were more likely to have impaired health-related quality of life. In multivariable analysis, patients with subcortical and/or brainstem infarcts had increased odds of impaired health-related quality of life (adjusted OR 2.54, 95% CI 1.29–5.01, p = 0.01).

Conclusions

After mild ischemic stroke, subcortical and brainstem infarct locations predict impairment in health-related quality of life.

Keywords

Quality of life stroke outcome ischemic stroke magnetic resonance imaging

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