Research findings leave considerable room for improvement in stroke treatment

Stroke treatments and prevention to improve quality of life for people who experience a stroke is poorer than researchers hoped, with stroke still taking nearly three out of five quality years off a person's life, according to a new study published in the October 9, 2013, online issue of Neurology®, the medical journal of the American Academy of Neurology. Researchers say the findings leave considerable room for improvement in stroke treatment.

Stroke is the leading cause of adult disability and the fourth-leading cause of death in the United States.

"These results highlight the severe toll that stroke takes on millions of people every year," said study author Peter M. Rothwell, FMedSci, a professor with the John Radcliffe Hospital in Oxford, United Kingdom. "This is the first study since the 1990s to look at long-term quality of life after stroke and transient ischemic attack (TIA)."

For the study, 748 people who experienced stroke and 440 who had a TIA were followed for five years and given questionnaires that measured quality of life and utility, which places a numerical value on the desirability of various health outcomes. These values, which were based on responses from members of the general public, range from "worse than death" to "perfect health." Participants were compared to an age-matched control group. These types of measures are increasingly used to determine the cost-effectiveness of new treatments.

The study determined the five-year quality-adjusted life years for the participants, calculated by multiplying the time spent in a health state by the value assigned to that particular health state. For example, the study found that out of a possible five years of perfect health, people who had a stroke lost 1.71 years due to earlier death and another 1.08 years due to a reduced quality of life, resulting in a reduction of 2.79 quality-adjusted life years. The results varied greatly depending on severity of the stroke, with those having a minor stroke experiencing 2.06 fewer quality-adjusted life years; moderate, 3.35 years; and severe, 4.3 quality years. People who had TIAs had 1.68 fewer quality-adjusted life years.

"Our study should serve as a wake-up call that we need more funding and research for stroke treatments and secondary stroke prevention measures to improve quality of life in stroke survivors," said Rothwell.