The Impact of Different Therapeutic Modalities (STANDARD TREATMENT, THROMBOLYSIS, THROMBECTOMY) on the Quality of Life of Stroke Patients

OBJECTIVES: Stroke is the second leading cause of death worldwide, and despite advances in acute treatment, it remains a leading cause of disability. The aim of our research is to examine the quality of life of patients who have experienced acute ischemic stroke under different therapeutic procedures (standard care, thrombolysis, thrombectomy).

METHODS: The study was conducted at the Department of Neurology, Clinical Center of the University of Pécs, between April 2022 and May 2023. The research is a quantitative, prospective, longitudinal follow-up study. Patients were categorized into groups based on treatment: intravenous thrombolysis (IVT), mechanical thrombectomy (MT), and standard care (SC). Modified Rankin Scale (mRS), NIH Stroke Scale (NIHSS), and European Quality of Life 5 Dimensions Scale (EQ-5D-5L) were used in the study.

RESULTS: The study included 198 participants (115 males, 83 females) (MT: 50, IVT: 69, SC: 79). Examination of pre-mRS and 30-day mRS values showed that in all three groups, the majority of patients fell into the mild category between 0-2 (Pre-mRS: 176 patients; 0.88%; 30-day mRS: 158 patients; 0.80%). The admission and discharge NIHSS values significantly improved in all three groups (IVT: 4.36 vs. 1.57, p <0.001; MT: 8.98 vs. 4.50, p <0.001; SC: 4.38 vs. 2.84, p <0.001). The EQ-5D value also significantly increased on days 1-3 and on day 30 after treatment in all groups (IVT: 0.82 vs. 0.88, p <0.001; MT: 0.63 vs. 0.73, p = 0.001; SC: 0.75 vs. 0.80, p = 0.014). Patients who were admitted with lower NIHSS values reported better quality of life by the end of our study (r: -0.43451).

CONCLUSIONS: At day 30, we observed significant improvement in quality of life in all three groups, with the highest improvement in the thrombectomy group.