Quality-Adjusted Life Expectancy (QALE) and Loss of QALE for Patients With Ischemic Stroke and Intracerebral Hemorrhage

Abstract

Background and Purpose-Few studies have evaluated the long-term health impact of stroke as categorized into different subtypes. The aim of this study is to quantify the loss of quality-adjusted life expectancy related to ischemic stroke and intracerebral hemorrhage. Methods-The hospital-based cohort, which consisted of 13 194 patients with first-ever stroke onset dates between 1995 and 2007, was classified into lacunar and nonlacunar infarctions and intracerebral hemorrhages. After linking with the National Mortality Registry, survival functions were determined and extrapolated over a 50-year period based on the survival ratio between the patients' survival and age-and sex-matched reference population's as calculated from the vital statistics of Taiwan. The survival functions were then multiplied by the quality of life assessed under the EuroQol 5-dimension (EQ-5D) questionnaire based on a sample of 486 patients with stroke. Results-The quality-adjusted life expectancy for a patient with ischemic stroke was 8.7 quality-adjusted life-years with an average loss of 8.3 quality-adjusted life-years, and there appeared to be no difference between lacunar and nonlacunar infarctions. Patients with intracerebral hemorrhage had a similar quality-adjusted life expectancy as those with ischemic stroke but with a significantly greater loss relative to the reference population (14.1 quality-adjusted life-years) because of younger ages. Conclusion-The lifelong health burden due to stroke was approximately 9.5 quality-adjusted life-years and should be considered in future cost-effectiveness analyses for prevention. (Stroke. 2010;41:739-744.)

Long-term prognosis after intracerebral haemorrhage: systematic review and meta-analysis

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Health-Related Quality of Life in Stroke Survivors at the University Hospital of the West Indies

“…The rationale for excluding intra-parenchymal or subarachnoid hemorrhagic stroke includes the fact that they make up the minority of stroke type in Jamaica with previous studies showing a prevalence of 11.1% and 5.3%, respectively, while ischemic stroke accounted for majority of stroke type with a prevalence of 83.6% [2]. Also hemorrhagic strokes are associated with higher mortality rates at initial presentation and previous studies have shown no difference in QOL outcomes when comparing these individuals to those with ischemic stroke [28][29][30]. Therefore, the information gained from including this stroke type would be minimal.…”

Progesterone Improves Neurobehavioral Outcome in Models of Intracerebral Hemorrhage

“…Intracerebral hemorrhage (ICH) represents up to 10-15% of all strokes in the United States alone and can result in a greater degree of morbidity, mortality, and loss of quality of life compared to ischemic stroke [1]. However, few improvements in outcome have been realized over the last 20 years, and no proven therapeutic intervention has been developed, as evidenced by recent costly multicenter clinical trials [2,3].…”