OBJECTIVE: A comparison of Neuro-QOL: cognitive health domains with mRS in acute ischemic strokeBACKGROUND: The modified Rankin scale (mRS) is a reliable objective measure of disability which has been widely applied in clinical trials. Health-related quality of life (QOL) measurements using Neuro-QOL acts as a continuous measurement of function from the patient perspective and provides validated measures of patient- reported outcomes. We compared QOL scores in cognitive health domains with mRS scores at 3 months after ischemic stroke or transient ischemic attack (TIA). Neuro- QOL measures included applied cognition - executive function (EF) and applied cognition - general concerns (GC).DESIGN/METHODS: From a single-center prospective cohort study, we identified ischemic stroke and TIA patients admitted between August 2012 and April 2013 who survived to 3-month follow-up and underwent mRS and Neuro-QOL outcomes assessments at 3 months. The mRS were assessed by structured telephone interviews and Neuro-QOL scores using short forms of executive function (EF) and general concerns (GC). We assessed the correlation between Neuro-QOL and mRS scores and evaluated the range of Neuro-QOL scores and identified mean T-scores in each mRS strata.RESULTS: Three-hundred twelve patients met study criteria (mean age 65.2 years; initial NIHSS score 4; 77.2% ischemic stroke). At 3 months, mean GC and EF T-scores were 53.5 (SD 7.7) and 51.3 (SD 10.5), respectively. Modest correlations were noted between mRS and cognitive function QOL T-scores at 3 months were mRS-EF: rs = -0.452 and mRS- GC: rs = -0.503. However, the range of T-scores was wide within mRS strata and correlation was non-linear. Among those with mRS 0-1, 19 of 252 patients (7.5%) had impaired Neuro-QOL GC or EF (> 1 SD below mean).CONCLUSIONS: The mRS correlates modestly but non-linearly with patient-reported scores of cognitive function using Neuro-QOL. Some patients report impairments in cognitive function despite no disability by mRS (i.e. 0-1). Therefore, Neuro-QOL provides a complementary tool for assessment of cognitive function after stroke.
Disclosure: Dr. Sangha has nothing to disclose. Dr. Corado has nothing to disclose. Dr. Bergman has nothing to disclose. Dr. Naidech has received research support from Gaymar Inc. Dr. Cella has received personal compensation for activities with Moffit Caner Center. Dr. Bernstein has received personal compensation for activities with Boehringer Ingelheim Pharmaceuticals, Inc., and Pfizer Inc. Dr. Curran has nothing to disclose. Dr. Prabhakaran has received personal compensation for activities with American Heart Association.
Original Article: http://www.neurology.org/cgi/content/short/82/10_Supplement/P2.116?rss=1
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