Variations in Health-Related Quality of Life (HRQoL) and survival 1 year after stroke: five European population-based registers

Salma Ahmed Mohamed Ayis, Ian Wellwood, Anthony Rudd, Christopher McKevitt, David Parkin, Charles Wolfe

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34 Citations (Scopus)


Objective There were two main objectives: to describe and compare clinical outcomes and Patient-Reported Outcome Measures (PROMs) collected using standardised procedures across the European Registers of Stroke (EROS) at 3 and 12 months after stroke; and to examine the relationship between patients’ Health-Related Quality of Life (HRQoL) at 3 months after stroke and survival up to 1 year across the 5 populations.

Design Analysis of data from population-based stroke registers.

Setting European populations in Dijon (France); Kaunas (Lithuania); London (UK); Warsaw (Poland) and Sesto Fiorentino (Italy).

Participants Patients with ischaemic or intracerebral haemorrhage (ICH) stroke, registered between 2004 and 2006.

Outcome measures (1) HRQoL, assessed by the physical component summary (PCS) and mental component summary (MCS) of the Short-Form Health Survey (SF-12), mapped into the EQ-5D to estimate responses on 5 dimensions (mobility, activity, pain, anxiety and depression, and self-care) and utility scores. (2) Mortality within 3 months and within 1 year of stroke.

Results Of 1848 patients, 325 were lost to follow-up and 500 died within a year of stroke. Significant differences in mortality, HRQoL and utility scores were found, and remained after adjustments. Kaunas had an increased risk of death; OR 2.34, 95% CI (1.32 to 4.14) at 3 months after stroke in Kaunas, compared with London. Sesto Fiorentino had the highest adjusted PCS: 43.54 (SD=0.96), and Dijon had the lowest adjusted MCS: 38.67 (SD=0.67). There are strong associations between levels of the EQ-5D at 3 months and survival within the year. The trend across levels suggests a dose–response relationship.

Conclusions The study demonstrated significant variations in survival, HRQoL and utilities across populations that could not be explained by stroke severity and sociodemographic factors. Strong associations between HRQoL at 3 months and survival to 1 year after stroke were identified.
Original languageEnglish
Number of pages10
JournalBMJ Open
Issue number6
Publication statusPublished - Jun 2015


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