Authors: Joana Costa Novo, José Vítor Gonçalves, Cláudia Lima, Rita Cagigal, Andrea Cabral, Mariana Rocha, Valéria Battistella, Ludovina Paredes, Tiago Gregório, Henrique Costa, Miguel Veloso, Ana Campolargo, Pedro Barros.
Introduction: It is well established that in the long-term, many stroke patients potentially have relevant functional incapacity related to deficits in domains other than motor; the burden of unmet long-term needs likely varies between different types of stroke or different healthcare systems. On the other hand, we can say that the ideal length of follow-up in a specialized consultation after ischemic stroke has not been established.
Methods: We evaluated long-term stroke patients who underwent endovascular treatment of anterior circulation in our stroke center and that were classified as “therapeutic success” (modified Rankin scale - mRS <3) at 3 months, to participate in an observational, cross-sectional study. Participants underwent a comprehensive interview and examination using validated standard questionnaires for Portuguese population to assess different life aspects after stroke as Post-Stroke Checklist, EQ-5D-3L scale, mRS, Barthel Index (BI), Burden Scale for Family Caregivers and Hamilton scale.
Results: We evaluated 36 patients. The mean age was 67.6 years old (±13,8) and the mean time for the interview was 52,8 (±9,9) months after the stroke. Most patients were independent, with a mean mRS of 1 (ranging from 0–3) and BI 95,4 (70-100). Sixty one percent had a clinically significant deficit in at least one domain. On the Post Stroke Checklist (PSC), 77,8% of participants demonstrated a not good perceived health status. EuroQoL index value was 0.750 (IQR 0.664–1.00). The two major disability parameters identified were in cognition (52,8%) and depression (27,8%). After review of the ongoing care by stroke specialists, in almost 2/3 of the patients, additional measures were proposed: additional etiological investigation (44%), physical or speech rehabilitation (~14%) or changes in pharmacological therapy (~3%).
Conclusion: These results highlight the prevalence and importance of non-motor disabilities in long-term stroke patients, even after short-term classification as “therapeutic success”. We also point out that even after more than 3 years of the stroke, additional therapeutic or etiological investigation measures were taken, reinforcing the need for individualized follow-up, without a pre-defined maximum follow-up time in a specialized cerebrovascular pathology consultation.
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