Determinants of health-related quality of life in stroke patients: A systematic review

Authors

DOI:

https://doi.org/10.62452/yg5s7r25

Keywords:

Quality of life, stroke, comorbidities, ischemic stroke, cognitive intervention

Abstract

This study, through a systematic review, analyzes the determining factors of health-related quality of life (HRQoL) in patients who have suffered cerebrovascular accident (CVA), one of the leading causes of disability and mortality worldwide. Based on a review of 12 articles published between 2019 and 2023, with a total of 2,343 patients, variables affecting HRQoL were identified: advanced age, female sex, type and severity of stroke, comorbidities, functional dependence, depression, anxiety, pain/discomfort, and limitations in mobility and daily activities. Ischemic stroke predominated (95.8%). The most commonly used instrument for assessment was the EQ-5D, validated as effective in measuring HRQoL. The results show that the most affected dimensions are physical quality, pain/discomfort, and functionality. Factors such as adequate rehabilitation, social support, and cognitive intervention programs can significantly improve quality of life. It is concluded that stroke negatively impacts both the physical and emotional aspects of patients, and that personalized interventions, early detection of emotional problems, and multidisciplinary work are key to optimizing recovery. Systematic assessment of HRQoL and emotional status is recommended to guide effective care strategies.

Downloads

Download data is not yet available.

Author Biography

  • Lizeth Alexandra Villarreal-Maya, Centro Clínico Quirúrgico Ambulatorio Hospital del Dia Nueva Loja Lago Agrio. Ecuador.

     

     

References

Abilova, G., Kamkhen, V., & Kalmatayeva, Z. (2023). Quality of Life of Patients Who Have Suffered from Acute Cerebrovascular Accident (Investigation Based on EQ-5D-5L). Medical Journal of The Islamic Republic of Iran, 37(8), 85–93. https://doi.org/10.47176/mjiri.37.85

Bártlová, S., Šedová, L., Havierniková, L., Hudáčková, A., & Dolák, F. (2022). Quality of Life of Post-stroke Patients. Zdr Varst., 61(2), 101–108. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8937589/

Center for Disease Control and Prevention. (2022). Stroke Facts. https://www.cdc.gov/stroke/facts.htm

Chen, Q., Cao, C., Gong, L., & Zhang, Y. (2019). Health related quality of life in stroke patients and risk factors associated with patients for return to work. Medicine, 98(16), e15130. https://doi.org/10.1097/MD.0000000000015130

De Graaf, J., Kuijpers, M., Visser-Meily, J., Kappelle, L., & Post, M. (2020). Validity of an enhanced EQ-5D-5L measure with an added cognitive dimension in patients with stroke. Clinical Rehabilitation, 34(4), 545–550. https://doi.org/10.1177/0269215520907990

De Graaf, J., Visser, J., Schepers, V., Baars, & Kappelle, J. (2021). Comparison between EQ-5D-5L and PROMIS-10 to evaluate health-related quality of life 3 months after stroke: a cross-sectional multicenter study. European Journal of Physical and Rehabilitation Medicine, 57(3), 56–63. https://doi.org/10.23736/S1973-9087.21.06335-8

Dopler, B. (2023). Stroke Prevention. Delaware Journal of Public Health, 9(3), 6–10. https://doi.org/10.32481/djph.2023.08.003

Fekadu, G., Chelkeba, L., & Kebede, A. (2019). Risk factors, clinical presentations and predictors of stroke among adult patients admitted to stroke unit of Jimma university medical center, south west Ethiopia: prospective observational study. BMC Neurology, 19(1). https://doi.org/10.1186/S12883-019-1409-0

Gandolfi, M., Donisi, V., Battista, S., Picelli, A., Valè, N., Del Piccolo, L., & Smania, N. (2021). Health-Related Quality of Life and Psychological Features in Post-Stroke Patients with Chronic Pain: A Cross-Sectional Study in the Neuro-Rehabilitation Context of Care. International Journal of Environmental Research and Public Health, 18(6), 3089. https://doi.org/10.3390/ijerph18063089

Grotta, J., Albers, G., Broderick, J., Day, A., Kasner, S., Lo, E., Sacco, R., & Wong, L. (2021). Stroke: Pathophysiology, Diagnosis, and Management. Elsevier.

Hui, C., Tadi, P., & Patti, L. (2022). Ischemic Stroke. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK499997/

Hurford, R., Sekhar, A., Hughes, T. A. T., & Muir, K. W. (2020). Diagnosis and management of acute ischaemic stroke. Practical Neurology, 20(4), 304–316. https://doi.org/10.1136/practneurol-2020-002557

Jauch, E. (2022). Ischemic Stroke: Practice Essentials, Background, Anatomy. Medscape, 14(1), 1–5. https://emedicine.medscape.com/article/1916852-overview

Kaffenberger, T., Bernhardt, J., Koehler, J. L., Ziegler, P. D., & Thijs, V. N. (2022). Ambulatory activity in stroke survivors associated with functional outcome and quality of life: An observational cohort study. Annals of Physical and Rehabilitation Medicine, 65(2), 101–115. https://doi.org/10.1016/j.rehab.2021.101540

Königsberg, A., DeMarco, A. T., Mayer, C., Wouters, A., Schlemm, E., Ebinger, M., Cho, T.-H., Endres, M., Fiebach, J. B., Fiehler, J., Galinovic, I., Puig, J., Thijs, V., Lemmens, R., Muir, K. W., Nighoghossian, N., Pedraza, S., Simonsen, C. Z., Gerloff, C., … Cheng, B. (2021). Influence of stroke infarct location on quality of life assessed in a multivariate lesion-symptom mapping study. Scientific Reports, 11(1), 134–142. https://doi.org/10.1038/s41598-021-92865-x

Kusec, A., Milosevich, E., Williams, O. A., Chiu, E. G., Watson, P., Carrick, C., Drozdowska, B. A., Dillon, A., Jennings, T., Anderson, B., Dawes, H., Thomas, S., Kuppuswamy, A., Pendlebury, S. T., Quinn, T. J., & Demeyere, N. (2023). Long-term psychological outcomes following stroke: the OX-CHRONIC study. BMC neurology, 23(1), 426. https://doi.org/10.1186/s12883-023-03463-5

Liu, Z., Zhou, X., Zhang, W., & Zhou, L. (2019). Factors associated with quality of life early after ischemic stroke: the role of resilience. Topics in Stroke Rehabilitation, 26(5), 335–341. https://doi.org/10.1080/10749357.2019.1600285

Mahesh, P. K. B., Gunathunga, M. W., Jayasinghe, S., Arnold, S. M., Senanayake, S., Senanayake, C., De Silva, L. S. D., & Kularatna, S. (2019). Construct validity and reliability of EQ-5D-3L for stroke survivors in a lower middle income setting. Ceylon Medical Journal, 64(2), 52–68. https://doi.org/10.4038/cmj.v64i2.8891

Mei, Y., Zhang, Z., Wu, H., Hou, J., Liu, X., Sang, S., Mao, Z., Zhang, W., Yang, D., & Wang, C. (2022). Health-Related Quality of Life and Its Related Factors in Survivors of Stroke in Rural China: A Large-Scale Cross-Sectional Study. Frontiers in Public Health, 10(2), 78–89. https://doi.org/10.3389/fpubh.2022.810185

Moreno, D., Santamaría, D., Ludeña, C., Astrid, B., & Vásquez, D. (2016). Enfermedad Cerebrovascular en el Ecuador: Análisis de los Últimos 25 Años de Mortalidad, Realidad Actual y Recomendaciones. Revista Ecuatoriana de Neurología, 25(1-3), 17–22. https://revecuatneurol.com/magazine_issue_article/enfermedad-cerebrovascular-ecuador-analisis-mortalidad-realidad-actual-recomendaciones/

Needham, D. M., Davidson, J., Cohen, H., Hopkins, R. O., Weinert, C., Wunsch, H., Zawistowski, C., Bemis-Dougherty, A., Berney, S. C., Bienvenu, O. J., Brady, S. L., Brodsky, M. B., Denehy, L., Elliott, D., Flatley, C., Harabin, A. L., Jones, C., Louis, D., Meltzer, W., … Harvey, M. A. (2012). Improving long-term outcomes after discharge from intensive care unit. Critical Care Medicine, 40(2), 502–509. https://doi.org/10.1097/CCM.0b013e318232da75

Orbell, S., Schneider, H., Esbitt, S., Gonzalez, J. S., Shreck, E., Batchelder, A., Gidron, Y., Pressman, S. D., Hooker, E. D., Wiebe, D. J., Rinehart, D., Hayman, L. L., Meneghini, L., Kikuchi, H., Desouky, T. F., McAndrew, L. M., Mora, P. A., … Turner, J. R. (2013). Health-related quality of life. En M. D. Gellman & J. R. Turner (Eds.), Encyclopedia of behavioral medicine (pp. 929–931). Springer.

Ortiz, J. (2018). La Enfermedad Cerebrovascular en Ecuador. Rev Ecuat Neurol, 27(1), 26–31. http://scielo.senescyt.gob.ec/scielo.php?pid=S2631-25812018000100007&script=sci_arttext

Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., … Moher, D. (2021). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ, 372. https://doi.org/10.1136/BMJ.N71

Rjoob, M., Hassan, N., Aziz, M., Mustafar, F., & Zakaria, M. (2023). The Effect of Dysphagia on Quality of Life in Stroke Patients. Clinical Archives of Communication Disorders, 8(2), 70–75. https://doi.org/10.21849/cacd.2023.00955

Schneider, S., Taba, N., Saapar, M., Vibo, R., & Kõrv, J. (2021). Determinants of Long-Term Health-Related Quality of Life in Young Ischemic Stroke Patients. Journal of Stroke and Cerebrovascular Diseases, 30(2), 105–119. https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.105499

Segerdahl, M., Hansson, P.-O., Samuelsson, C. M., & Persson, C. U. (2023). Health-related quality of life in stroke survivors: a 5-year follow-up of The Fall Study of Gothenburg (FallsGOT). BMC Geriatrics, 23(1), 584–596. https://doi.org/10.1186/s12877-023-04308-z

Su, Y., Asamoto, M., Yuki, M., Saito, M., Hasebe, N., Hirayama, K., Otsuki, M., & Iino, C. (2021). Predictors and short‐term outcomes of post‐stroke fatigue in initial phase of transition from hospital to home: A prospective observational study. Journal of Advanced Nursing, 77(4), 1825–1838. https://doi.org/10.1111/jan.14731

Taroza, S., Burkauskas, J., Mickuviene, N., Kazukauskiene, N., & Podlipskyte, A. (2023). Psychometrics and validation of the EQ-5D-5L instrument in individuals with ischemic stroke in Lithuania. Frontiers in Psychology, 14(2), 159–164. https://doi.org/10.3389/fpsyg.2023.1284859

Tham, X., Phua, V., Ho, E., Yan, T., Chen, N., Zuo, L., Thompson, C., & Dong, Y. (2023). Train-your-brain program to reduce depression, anxiety, and stress in stroke survivors: a pilot community-based cognitive intervention study. Frontiers in Neurology, 14(2), 56–63. https://doi.org/10.3389/fneur.2023.1163094

Downloads

Published

2025-09-13

How to Cite

Bustamante-Lalangui, T. M. ., Córdova-Lalangui, J. L. ., Cordovilla-Córdova, D. K. ., Villarreal-Maya, L. A. ., Zhingre-Córdova, J. F. ., & Córdova-Ávila, M. D. . (2025). Determinants of health-related quality of life in stroke patients: A systematic review. Revista Metropolitana De Ciencias Aplicadas, 8(S2), 287-295. https://doi.org/10.62452/yg5s7r25