Changes in Health-Related Quality of Life After Transient Ischemic Attack
| Autor: | Sidra L Speaker, Christine Doherty, Lynn Daboul, Irene L. Katzan, Brittany Lapin, Ken Uchino, Andrew Schuster |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty Health Status Population Ambulatory Care Facilities Quality of life Interquartile range Internal medicine Outpatients Global health Humans Medicine Patient Reported Outcome Measures skin and connective tissue diseases education Stroke Original Investigation Aged education.field_of_study business.industry Research General Medicine Middle Aged medicine.disease Mental health Online Only Neurology Ischemic Attack Transient Ambulatory Quality of Life Female sense organs business Cohort study |
| Zdroj: | JAMA Network Open |
| ISSN: | 2574-3805 |
| Popis: | This cohort study investigates changes in patient-reported global health as measured before vs after transient ischemic attack. Key Points Question Does health-related quality of life (HRQOL) worsen after transient ischemic attack (TIA)? Findings In this cohort study of 263 patients who completed a patient-reported assessment of their global health as part of routine care before and after TIA, mean baseline physical health summary score was statistically significantly decreased compared with the general population, and the difference was clinically relevant. Physical health and mental health summary scores were not statistically significantly different after the event compared with before the event. Meaning These findings suggest that the impaired HRQOL found among patients diagnosed with TIA reflects an impaired premorbid state of health rather than worsening health after the TIA event. Importance Numerous studies have found that patients diagnosed with TIA have decreased health-related quality of life, which has been interpreted as suggesting that patients with TIA have residual symptoms after the event. Studies assessing health status in the same patients before and after an event are lacking but may allow a direct determination of the association of TIA with postevent health status. Objective To examine patient-reported health before transient ischemic attack (TIA) among individuals diagnosed with this event and evaluate change in patient-reported health after the event overall and by TIA characterization subgroups. Design, Setting, and Participants This cohort study was conducted among 236 patients with a clinical diagnosis of TIA from October 2015 to December 2017 in a large US health system that collects a patient-reported outcome measure in ambulatory setting as part of routine care. Included patients had patient-reported global health scale assessments completed as part of routine care before and after a TIA event. Data were analyzed from March through July 2020. Main Outcomes and Measures The main outcome was Patient-Reported Outcome Measurement Information System Global Health (PROMIS GH) scale score before and after TIA. A change of 5 or more points in this score is considered clinically relevant. The secondary outcomes included change in patient-reported global health by clinical impression of the probability of a TIA event, pattern of neurological deficits, and short-term risk of stroke, as assessed by the ABCD2 score. Results Among 263 patients who experienced TIA, mean (SD) age was 67.9 (13.4) years and 138 (52.5%) were women. The median (interquartile range) time between patient-reported global health scores was 152 (94-284) days. Mean (SD) baseline patient-reported global physical health and mental health scale summary scores were 43.4 (8.2) and 47.7 (9.7), respectively, and were statistically significantly decreased compared with the general population mean (SD) scores of 50 (10; P |
| Databáze: | OpenAIRE |
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