Authors: Dewilde S, Peeters A, Thijs V, Annemans L, Belgian SC
Published in: Value in Health. 2014 Nov;17(7):A495
Objectives: To investigate the living and employment situation of patients after stroke, and examine whether this differs by degree of disability.
Methods: We conducted an observational retrospective study among 569 post-stroke patients and examined changes in employment and living situation. The investigational period was divided into 3 intervals:< 3,3-6 and> 6 months after stroke. All patients had their mRS (modified Rankin Score, ranging from 0 full health to 5 severely dependent) measured at 3 months after stroke, plus an additional mRS assessment if their stroke was more than 6 months ago. Patients were recruited in 10 regional and university hospitals across Belgium using a convenience sample stratified by mRS.
Results: Before their stroke the majority of patients lived at home (99%)despite the fact that 13% had a previous stroke. At 3 months after stroke an association was found between the time spent in an inpatient care facility (hospital, rehabilitation facility, nursing home) and the mRS (p< 0.0001 Weibull survival analysis, average inpatients days were 9.2, 14.1, 27.7, 53.4, 67.0 and 73.4 for mRS 0-5 respectively). Between 3 and 6 months after stroke on average 7% of patients were staying in a rehabilitation facility and 5% in a nursing home; these were mostly patients with mRS> = 3. After six months all patients returned home, except patients withmRS4 (36% home) and mRS5 (38% home). Before stroke 70% of patients were retired; in those working before their stroke, 16-20% patients in mRS categories 0-2 were working again compared to none in mRS category 3-5, of which 14% took early retirement or leave of absence.
Conclusions: Experiencing a mild stroke will not affect the patient’s employment and living situation beyond the short term; however suffering a severe stroke is likely to lead to significant changes in place of residence and occupation.