22. European Stroke Conference 67 Stroke prognosis Long-term prognosis of ischemic stroke in young adults: cognitive and psychological factors affecting the quality of life. M.A.A.M. de Bruijn1, N.E. Synhaeve2, M. van Rijsbergen3, F.E. de Leeuw4, B.P.W. Jansen5, P.L.M. de Kort6 St. Elisabeth Hospital, Tilburg, THE NETHERLANDS1, St. Elisabeth Hospital, Tilburg, THE NETHERLANDS2, University of Tilburg, Tilburg, THE NETHERLANDS3, Radboud University Nijmegen Medical Centre, Nijmegen, THE NETHERLANDS4, St. Elisabeth Hospital, Tilburg, THE NETHERLANDS5, St. Elisabeth Hospital, Tilburg, THE NETHERLANDS6 Background: Prognosis in young stroke patients is important because they usually have longer life expectancy and other daily life demands. However, little is known on this. We aimed to determine which medical, cognitive and psychological factors influence the quality of life (QoL) in young stroke patients (<50 years), after long-term follow-up. Methods: Young stroke patients admitted to the St. Elisabeth hospital and the TweeSteden hospital, Tilburg, the Netherlands, between 2000-2010 were included. Baseline variables as stroke severity were derived from medical records. Patients were asked to fulfil the following questionnaires: (1) the Hospital Anxiety and Depression Scale (HADS), (2) the Fatigue Assessment Scale (FAS) and (3) the shortened World Health Organization Quality of Life (WHOQOL-BREF26). Adjacent to it pa-tients were asked to participate in a neuro-psychological examination. Using linear multiple regres-sion analysis we assessed the factors influencing quality of life. Results: 193 patients (64.1%) out of 350 eligible patients fulfilled the questionnaires of whom 110 (57.0%) completed a neuro-psychological examination. Mean follow-up period was 55.8 (± 34.3) months. Using scaled z-scores, there was a trend towards lower mental speed than would be ex-pected in the overall population. On the other cognitive domains no problems were detected. 30.8% patients of the patients fulfilled the criteria for depression and 30.4% for an anxiety disorder based on the HADS. Fatigue was associated with all domains of quality of life (p<0.03). Depression was associated with general and psychological health (resp. p=0.001 and p= 0.01). Conclusions: Principally psychological factors, as fatigue and depression, seem to affect the quality of life in young adults after cerebral ischemia. Faster recognition and more adequate treatment of these problems could improve the quality of life. 314 © 2013 S. Karger AG, Basel Scientific Programme 68 Stroke prognosis Poor long term functional outcome after young stroke: the FUTURE Study. N.E. Synhaeve1, N.A.M. Maaijwee2, L.C.A. Rutten-Jacobs3, R.M. Arntz4, H.C. Schoonderwaldt5, L.D.A. Dorresteijn6, P.L.M. de Kort7, E.J. van Dijk8, F.E. de Leeuw9 Radboud University Nijmegen Medical Centre, the Netherlands, Nijmegen, THE NETHER-LANDS1, Radboud University Nijmegen Medical Centre, the Netherlands, Nijmegen, THE NETH-ERLANDS2, Radboud University Nijmegen Medical Centre, the Netherlands, Nijmegen, THE NETHERLANDS3, Radboud University Nijmegen Medical Centre, the Netherlands, Nijmegen, THE NETHERLANDS4, Radboud University Nijmegen Medical Centre, the Netherlands, Nijme-gen, THE NETHERLANDS5, Radboud University Nijmegen Medical Centre, the Netherlands, Ni-jmegen, THE NETHERLANDS6, St. Elisabeth Hospital, Tilburg, THE NETHERLANDS7, Radboud University Nijmegen Medical Centre, the Netherlands, Nijmegen, THE NETHERLANDS8, Rad-boud University Nijmegen Medical Centre, the Netherlands, Nijmegen, THE NETHERLANDS9 Background: Long-term functional outcome is of key interest to young stroke survivors as they usu-ally have a long life expectancy. However, little is known on this. Objective: To investigate the long-term functional outcome after young (<50 years) transient isch-emic attack (TIA), ischemic stroke (IS) or intracranial haemorrhage (ICH). Methods: Young stroke survivors admitted to our department between 1/1/1980 and 11/1/2010 were included. Baseline variables including, stroke severity, neurological status at discharge, incident vas-cular disease were collected. Functional outcome was assessed during follow up by stroke subtype and was considered good with a Modified Rankin Scale (mRS)<3, Barthel-index > 90% and instru-mental Activities of Daily Living =8. Results: There were 550 patients (mean age index event 39.9 years (SD 8.0); 59.1% suffered an ischemic stroke, 33.6% a TIA and 7.3% and ICH; 45,1% were male). At discharge 82.9% of all pa-tients had a good functional outcome on the mRS. After a mean follow-up of 9.8 (SD±8.4) years 89.3% of all stroke patients had a good outcome, however only 87.4% of IS and 85% of ICH pa-tients had a good outcome, even after almost ten years. The proportion of patients with a good out-come decreased after longer follow-up (90.7%, 93.3%, 83.2% with good outcome after a follow up < 5 years, 5-15 years and > 15 years, respectively, p=0.009). Risk factors for poor outcome included recurrent stroke (OR 163.6; CI 1.4-19395.9 for TIA patients) and (OR 14.8; CI 5.1-42.8 for IS patients), age (OR 1.1; CI 1.0-1.2), a 1-point increase in NIHSS score at admission (OR 1.3; CI 1.2-1.4) and other incident cardiovascular disease (OR 4.9; CI 1.2- 19.3). Conclusions: One out of six young stroke patients is dependent in daily life, even ten years after stroke. This happens in an important period of life, during which important decisions regarding work and family life have to be made. Our data should be taken into account when counselling these patients. Figure 1 Bar diagram showing the outcome on the modified rankin scale at follow-up for all patients (n=550)
Karger_ESC London_2013
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