Thrombolysis treatment protected impairment of functional ability, quality of life and fatigue seven years after stroke

J Stroke Cerebrovasc Dis. 2024 Jun;33(6):107707. doi: 10.1016/j.jstrokecerebrovasdis.2024.107707. Epub 2024 Mar 30.

Abstract

Objectives: We studied quality of life, functional outcome, depression, and fatigue of ischemic stroke patients treated with or without thrombolysis seven years post-stroke.

Materials and methods: A total of 204 ischemic stroke patients treated with or without thrombolysis during 2013-2015. After seven years the 136 survivors were assessed with telephone interview, which included questions about subjective quality of life (European Quality of Life-5 Dimensions), depression, fatigue with Fatigue Severity Scale, functional ability assessed with Barthel Index and Modified Rankin Scale, living conditions, need of care, and medical aids.

Results: At admission patients with thrombolysis had higher National Institutes of Health Stroke Scale scores compared with those not treated with thrombolysis. At seven years post-stroke, 99% of alive patients answered the questionnaires. There were no group differences concerning functional outcome, quality of life, depression, fatigue, or insomnia. The Barthel Index was normal in both groups. The quality of life was good in both groups without group differences in any domains. Of all patients, 68% reported no problems in usual activities, and 61% were without pain. Anxiety or depression were experienced by 19% of all stroke patients, while fatigue was present in 32% of cases.

Conclusions: Seven years post-stroke the quality of life was good and functional outcome remained in good level in both study groups. One third experienced fatigue, while every fifth experienced depression. The thrombolysis treatment seems to protect from decreased quality of life, fatigue, and decreased mobility, self-care, and usual activities despite more severe stroke.

Keywords: Fatigue; Functional ability; Ischemic stroke; Quality of life; Thrombolysis.

MeSH terms

  • Activities of Daily Living
  • Aged
  • Aged, 80 and over
  • Depression* / diagnosis
  • Depression* / drug therapy
  • Depression* / etiology
  • Depression* / psychology
  • Disability Evaluation*
  • Fatigue* / diagnosis
  • Fatigue* / drug therapy
  • Fatigue* / etiology
  • Fatigue* / physiopathology
  • Female
  • Fibrinolytic Agents* / administration & dosage
  • Fibrinolytic Agents* / adverse effects
  • Functional Status*
  • Humans
  • Ischemic Stroke* / diagnosis
  • Ischemic Stroke* / drug therapy
  • Ischemic Stroke* / physiopathology
  • Ischemic Stroke* / therapy
  • Male
  • Middle Aged
  • Quality of Life*
  • Recovery of Function*
  • Risk Factors
  • Thrombolytic Therapy* / adverse effects
  • Time Factors
  • Treatment Outcome

Substances

  • Fibrinolytic Agents