Quality of Life After Endovascular Thrombectomy for Acute Ischemic Stroke in Northern Finland

Abstract

Objectives: Endovascular thrombectomy has demonstrated a major therapeutic improvement in the treatment of acute ischemic stroke. The benefit of endovascular thrombectomy is commonly reported by determining the functional outcome using the modified Rankin Scale (mRS). There is a lack of knowledge concerning the quality of life (QoL) and factors impacting the QoL after endovascular thrombectomy. The aim of this study was to assess the QoL of stroke survivors who underwent endovascular thrombectomy and to determine the variables associated with QoL.

Methods: Prospective single-center analysis of 98 patients who underwent endovascular thrombectomy between 2015 and 2019. QoL was assessed by using the Rand 36-Item Health Survey (RAND-36), Beck’s Depression Inventory (BDI), Stroke Impact Scale-16 (SIS-16), and Alcohol Use Disorders Identification Test (AUDIT) questionnaires.

Results: Of the 98 patients, 53 (54.1%) reported poor QoL. According to the logistic regression analysis, the National Institutes of Health Stroke Scale (NIHSS) score > 6 on the first postprocedural day, right hemispheric infarction, and depression were independently associated with poor QoL. Depression was reported by 40.8% of all the respondents. QoL scores of the patients treated with endovascular thrombectomy were impaired in physical functioning, physical and emotional role functioning, social functioning, and general health compared to the age-adjusted values of the Finnish general population.

Conclusion: Endovascular thrombectomy (EVT)-treated stroke survivors experience disability in multiple levels. More than half of the patients report poor QoL. Neurological disability, functional dependence, depression, and comorbidities are associated with poor QoL. Social capability is impaired and the difficulties are more distinct among individuals with age above 65 years.