Coping Strategies, Quality of Life, and Neurological Outcome in Patients Treated with Mechanical Thrombectomy after an Acute Ischemic Stroke
Abstract
:1. Introduction
2. Materials and Methods
2.1. Design
2.2. Participants
2.3. Measures and Instruments
2.4. Ethics Statement
2.5. Data Analysis
3. Results
4. Discussion
Limitations of the Study and Future Research
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Sociodemografic and Clinical-Pathological Characteristics | Total (n = 82) | EVT (n = 42) | BMT (n = 40) | p-Value |
---|---|---|---|---|
Age (years) | 67.60 (10.40) | 66.76 (10.15) | 68.47 (10.72) | 0.406 |
Sex (male) | 43 (52.4) | 23 (54.8) | 20 (50) | 0.204 |
Medical history | ||||
Psychiatric history | 11 (13.4) | 8 (19) | 3 (7.5) | 0.128 |
Hypertension | 55 (67.1) | 27 (64.3) | 28 (70) | 0.582 |
Diabetes mellitus | 22 (26.8) | 12 (28.6) | 10 (25) | 0.715 |
Dyslipidaemia | 52 (63.4) | 26 (61.9) | 26 (65) | 0.775 |
Ischemic heart disease | 42 (51.2) | 20 (47.6) | 22 (55) | 0.504 |
Cancer | 11 (13.4) | 5 (11.9) | 6 (15) | 0.681 |
Previous stroke | 7 (8.5) | 1 (2.4) | 6 (15) | 0.041 |
Previous TIA | 3 (3.7) | 1 (2.4) | 2 (5) | 0.337 |
Toxic habits | ||||
Alcohol | 0.786 | |||
Never | 65 (79.3) | 33 (78.6) | 32 (80) | |
Moderate | 13 (15.9) | 7 (16.7) | 6 (15) | |
Severe | 3 (3.7) | 1 (2.4) | 2 (5) | |
Former | 1 (1.2) | 1 (2.4) | 0 | |
Smoking | 0.661 | |||
Never | 53 (64.6) | 26 (61.9) | 27 (67.5) | |
Moderate | 11 (13.4) | 6 (14.3) | 5 (12.5) | |
Excessive | 5 (6.1) | 3 (7.1) | 2 (5) | |
Former | 13 (15.9) | 7 (16.7) | 6 (15) |
COPE-28 Items | Total (n = 50) | COPE-28 (3 Months) | p-Value | COPE-28 (1 Year) | p-Value |
---|---|---|---|---|---|
Active coping | EVT: 23 | 3.92 [1.99] | 0.267 | 3.63 [2.10] | 0.030 |
Items 2 and 10 | BMT: 27 | 4.52 [1.83] | 4.74 [1.43] | ||
Planning | EVT: 23 | 2.96 [1.88] | 0.465 | 2.79 [2.10] | 0.637 |
Items 6 and 26 | BMT: 27 | 3.37 [2.10] | 3.07 [2.13] | ||
Use of emotional support | EVT: 23 | 3.92 [2.30] | 0.753 | 4.25 [2.07] | 0.597 |
Items 9 and 17 | BMT: 27 | 4.11 [2.08] | 4.56 [2.03] | ||
Social support | EVT: 23 | 3.04 [1.76] | 0.195 | 3.21 [1.64] | 0.458 |
Items 1 and 28 | BMT: 27 | 3.67 [1.64] | 3.59 [1.99] | ||
Religion | EVT: 23 | 1.79 [2.32] | 0.574 | 2.50 [2.54] | 0.403 |
Items 16 and 20 | BMT: 27 | 1.44 [2.06] | 1.93 [2.32] | ||
Positive reframing | EVT: 23 | 2.54 [2.18] | 0.886 | 2.83 [1.99] | 0.164 |
Items 14 and 18 | BMT: 27 | 2.63 [2.15] | 3.63 (2.02) | ||
Acceptance | EVT: 23 | 4.21 [1.79] | 0.795 | 4.25 [1.65] | 0.034 |
Items 3 and 21 | BMT: 27 | 4.33 [1.62] | 5.00 [1.39] | ||
Denial | EVT: 23 | 1.17 [1.63] | 0.441 | 0.92 [1.25] | 0.339 |
Items 5 and 13 | BMT: 27 | 1.56 [1.91] | 1.33 [1.75] | ||
Humor | EVT: 23 | 1.33 [1.93] | 0.944 | 1.29 [1.85] | 0.830 |
Items 7 and 19 | BMT: 27 | 1.37 [1.82] | 1.19 [1.67] | ||
Self-distraction | EVT: 23 | 3.00 [2.04] | 0.499 | 2.75 [1.87] | 0.299 |
Items 4 and 22 | BMT: 27 | 2.59 [2.21] | 3.33 [2.08] | ||
Self-blame | EVT: 23 | 1.29 [1.57] | 0.945 | 1.33 [1.50] | 0.548 |
Items 8 and 27 | BMT: 27 | 1.26 [1.77] | 1.63 [1.95] | ||
Behavioral disengagement | EVT: 23 | 1.33 [1.69] | 0.728 | 0.71 [1.08] | 0.463 |
Items 11 and 25 | BMT: 27 | 1.19 [1.33] | 0.96 [1.34] | ||
Venting | EVT: 23 | 1.25 [1.26] | 0.496 | 1.54 [1.50] | 0.906 |
Items 12 and 23 | BMT: 27 | 1.52 [1.50] | 1.59 [1.55] | ||
Substance abuse | EVT: 23 | 0.21 [0.66] | 0.202 | 0.13 [0.61] | 0.697 |
Items 15 and 24 | BMT: 27 | 0.04 [0.19] | 0.19 [0.48] |
Neurological and Functional Scales | Total (n = 82) | EVT (3 Months; n = 42) (1 Year; n = 35) | BMT (3 Months; n = 35) (1 Year; n = 31) | p-Value |
---|---|---|---|---|
Baseline NIHSS | 16 [13−19] | 15 [11−19] | 17 [14−19] | 0.225 |
NIHSS 24 h | 10 [4−15] | 6 [3−13] | 11 [7−17] | 0.013 |
NIHSS 3 months | 7 [1−11] | 2 [1−12] | 5 [3−11] | 0.071 |
NIHSS 1 year | 5 [1−7] | 4 [0−8] | 6 [1−7] | 0.484 |
Previous BI | 100 | 100 | 100 | 1.000 |
BI 3 months | 80 [10−98] | 80 [13−100] | 70 [10−95] | 0.184 |
BI 1 year | 76 [60−100] | 78 [65−100] | 74 [60−95] | 0.336 |
Previous mRS | 0 [0−0] | 0 [0−0] | 0 [0−1] | 0.355 |
mRS 3 months | 3 [2−5] | 2 [2−5] | 3 [2−5] | 0.178 |
mRS 1 year | 3 [2−3] | 2 [2−3] | 3 [2−3] | 0.536 |
SIS-16 3 months | 53 [21−73] | 59 [22−75] | 48 [16−70] | 0.269 |
SIS-16 1 year | 57 [46−76] | 60 [53−78] | 54 [37−71] | 0.178 |
Neurological and Functional Scales | 3 Months | 1 Year | ||||
---|---|---|---|---|---|---|
EVT (n = 42) | BMT (n = 40) | p-Value | EVT (n = 35) | BMT (n = 31) | p-Value | |
NIHSS [0–2] | 22 (81.5) | 8 (61.5) | 0.314 | 17 (60.7) | 14 (53.8) | 0.876 |
mRS [0–2] | 21 (50) | 11 (27.5) | 0.029 | 20 (47.6) | 11 (27.5) | 0.119 |
BI [95–100] | 16 (43.6) | 12 (35.3) | 0.881 | 17 (65.4) | 13 (52) | 0.332 |
SIS-16 [40–80] | 27 (65.9) | 24 (60) | 0.585 | 28 (80) | 23 (74.2) | 0.574 |
HRQoL | EVT 3 Months (n = 40) | BMT 3 Months (n = 36) | p-Value | EVT 1 Year (n = 35) | BMT 1 Year (n = 31) | p-Value |
---|---|---|---|---|---|---|
Mobility | 0.204 | 0.635 | ||||
I have no trouble walking | 21 (52.5) | 12 (33.3) | 18 (51.4) | 13 (41.9) | ||
I have some trouble walking | 11 (27.5) | 16 (44.4) | 12 (34.3) | 14 (45.2) | ||
I have to stay in bed | 8 (20) | 8 (22.2) | 5 (14.3) | 4 (12.9) | ||
Personal care | 0.129 | 0.514 | ||||
I have no problems with personal care | 21 (52.5) | 12 (33.3) | 20 (57.1) | 14 (45.2) | ||
I have some difficulty in washing or dressing myself | 7 (17.5) | 13 (36.1) | 7 (20) | 10 (32.3) | ||
I am unable to wash or dress myself | 12 (30) | 11 (30.6) | 8 (22.9) | 7 (22.6) | ||
Daily activities | 0.645 | 0.792 | ||||
I have no problems | 12 (30) | 8 (22.2) | 10 (28.6) | 8 (25.8) | ||
I have some problems | 15 (37.5) | 13 (36.1) | 13 (37.1) | 13 (41.9) | ||
I am unable to do daily activities | 13 (32.5) | 15 (41.7) | 12 (34.3) | 10 (32.3) | ||
Pain/discomfort | 0.012 | 0.426 | ||||
I have no pain or discomfort | 22 (55) | 10 (27.8) | 17 (48.6) | 11 (35.5) | ||
I have moderate pain or discomfort | 11 (27.5) | 22 (61.1) | 14 (40) | 13 (41.9) | ||
I have a lot of pain or discomfort | 7 (17.5) | 4 (11.1) | 4 (11.4) | 7 (22.6) | ||
Anxiety/depression | 0.838 | 0.797 | ||||
I am not anxious or depressed | 13 (32.5) | 10 (27.8) | 12 (34.3) | 12 (38.7) | ||
I am moderately anxious or depressed | 20 (50) | 18 (50) | 18 (51.4) | 15 (48.4) | ||
I am very anxious or depressed | 7 (17.5) | 8 (22.2) | 5 (14.3) | 4 (12.9) | ||
EQ-5D index | 0.760 (0.177) | 0.692 (0.150) | 0.078 | 0.763 (0.160) | 0.731 (0.167) | 0.440 |
EQ-VAS (0–100) | 60 [40–75] | 50 [21–70] | 0.053 | 58 [50–75] | 56 [40–80] | 0.707 |
Variable | B | Standard Error | β | p-Value | (CI 95%) | |
---|---|---|---|---|---|---|
Lower Limit | Upper Limit | |||||
Constant | 1.013 | 0.065 | 0.000 | 0.883 | 1.143 | |
Age | 0.001 | 0.001 | 0.049 | 0.400 | −0.001 | 0.003 |
Sex | −0.015 | 0.018 | 0.046 | 0.405 | −0.052 | 0.021 |
Treatment (EVT) | 0.039 | 0.019 | 0.118 | 0.038 | 0.002 | 0.077 |
NIHSS | 0.003 | 0.002 | 0.129 | 0.110 | −0.001 | 0.007 |
mRS | −0.078 | 0.009 | −0.739 | 0.000 | −0.096 | −0.061 |
Pain/discomfort dimension (EQ-5D) | −0.078 | 0.016 | −0.330 | 0.000 | −0.111 | −0.046 |
Variable | B | Standard Error | β | p-Value | (CI 95%) | |
---|---|---|---|---|---|---|
Lower Limit | Upper Limit | |||||
Constant | 1.063 | 0.066 | 0.000 | 0.930 | 1.195 | |
Age | 0.001 | 0.001 | 0.059 | 0.319 | −0.001 | 0.003 |
Sex | −0.016 | 0.019 | −0.050 | 0.393 | −0.054 | 0.021 |
Treatment (EVT) | −0.131 | 3.566 | −0.003 | 0.971 | −7.266 | 7.004 |
NIHSS | −0.001 | 0.003 | −0.023 | 0.805 | −0.006 | 0.004 |
mRS | −0.070 | 0.011 | −0.595 | 0.000 | −0.092 | −0.048 |
Pain/discomfort dimension (EQ-5D) | −0.099 | 0.014 | −0.441 | 0.000 | −0.127 | −0.070 |
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Reverté-Villarroya, S.; Dávalos, A.; Font-Mayolas, S.; Berenguer-Poblet, M.; Sauras-Colón, E.; López-Pablo, C.; Sanjuan-Menéndez, E.; Muñoz-Narbona, L.; Suñer-Soler, R. Coping Strategies, Quality of Life, and Neurological Outcome in Patients Treated with Mechanical Thrombectomy after an Acute Ischemic Stroke. Int. J. Environ. Res. Public Health 2020, 17, 6014. https://doi.org/10.3390/ijerph17176014
Reverté-Villarroya S, Dávalos A, Font-Mayolas S, Berenguer-Poblet M, Sauras-Colón E, López-Pablo C, Sanjuan-Menéndez E, Muñoz-Narbona L, Suñer-Soler R. Coping Strategies, Quality of Life, and Neurological Outcome in Patients Treated with Mechanical Thrombectomy after an Acute Ischemic Stroke. International Journal of Environmental Research and Public Health. 2020; 17(17):6014. https://doi.org/10.3390/ijerph17176014
Chicago/Turabian StyleReverté-Villarroya, Silvia, Antoni Dávalos, Sílvia Font-Mayolas, Marta Berenguer-Poblet, Esther Sauras-Colón, Carlos López-Pablo, Estela Sanjuan-Menéndez, Lucía Muñoz-Narbona, and Rosa Suñer-Soler. 2020. "Coping Strategies, Quality of Life, and Neurological Outcome in Patients Treated with Mechanical Thrombectomy after an Acute Ischemic Stroke" International Journal of Environmental Research and Public Health 17, no. 17: 6014. https://doi.org/10.3390/ijerph17176014