Long-term health-related quality of life, survival and costs by different levels of functional outcome six months after stroke.

Introduction: Information about the impact of functional outcome after stroke is currently missing on health-related quality of life, survival and costs. This information would be valuable for health economic evaluations and for allocation of resources in stroke health care.

Patients And Methods: Data on 297 Swedish patients included in the Third International Stroke Trial were analysed including functional outcome at six months (measured by Oxford Handicap Scale), health-related quality of life up to 18 months (EQ-5D-3L) and survival up to 36 months. We used record linkage to collect data on costs up to 36 months, using national patient registers.

Results: Patients with a better functional outcome level at six months had a significantly better health-related quality of life at 18 months ( < 0.05), better long-term survival ( < 0.05) and lower costs ( < 0.001), for all time points up to 36 months. The difference in costs was mainly due to differences in days spent in hospital ( < 0.005).

Discussion: This study showed an association between functional outcome at six months and health-related quality of life up to 18 months, and costs up to 36 months.

Conclusion: Functional outcome six months after stroke is an important determinant of health-related quality of life, survival and costs over 36 months. Effective interventions aimed at reducing short-term disability levels are therefore also expected to reduce the overall burden of stroke.