Objective Health-related quality of life (HRQL) instruments are patient or proxy-reported outcome measures that provide a comprehensive and subjective assessment of patient’s well-being and hence vital for health outcomes evaluation. A clear and thorough understanding of HRQL and its determinants is especially important to appropriately guide health-improving interventions. In this study, HRQL of paediatric arterial ischaemic stroke survivors was assessed using guidelines recommended for interpretation and reporting of the patient-reported outcome data. Determinants of HRQL were also explored.
Methods Children diagnosed with arterial ischaemic stroke between 2003 and 2012 were assessed at least 1 year poststroke using the parent–proxy report versions of the Pediatric Quality of Life Inventory 4.0 and Pediatric Stroke Recurrence and Recovery Questionnaire. HRQL data were compared with population norms and used as outcome in multiple linear regression analysis.
Results 59 children were evaluated. Mean age at diagnosis of stroke was 2.2 years. Mean age at assessment and time elapsed since stroke was 7 years and 5 years, respectively. A total of 41% children had normal global outcome, whereas 51% had moderate to severe deficits. A lower overall HRQL was observed in both self and proxy reports. Parents reported the maximum impairment in emotional domain, whereas children indicated physical functioning to be the most affected. Neurological outcome, site of stroke and socioeconomic status were independently associated with overall HRQL.
Conclusions Lower HRQL was demonstrated in children who survived arterial ischaemic stroke. Socioeconomic status of families was an important determinant of HRQL, over and above clinical parameters.
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Contributors SKG conceptualied and designed the study, conducted the study, performed the statistical analysis, drafted the initial manuscript and approved the final manuscript as submitted. JAJ helped in study design and interpretation of study findings, critically reviewed the manuscript and approved the final manuscript as submitted. WQ helped in statistical analysis, critically reviewed the manuscript and approved the final manuscript as submitted. ASN and CR helped in study design, critically reviewed the manuscript and approved the final manuscript as submitted. JYY conceptualised and designed the study, reviewed the neuroimaging, reviewed and revised the manuscript and approved the final manuscript as submitted. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.
Funding This work was supported by Alberta Innovates Health Solutions (AIHS) graduate studentship number (20120876) and Women’s and Children’s Health Research Institute (WCHRI) graduate studentship.
Competing interests None declared.
Patient consent Parental/guardian consent obtained.
Ethics approval The study was approved by the Health Research Ethics Board, University of Alberta.
Provenance and peer review Not commissioned; externally peer reviewed.
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