OBJECTIVES: To review the health-related quality of life studies focus on ischemic stroke (IS) and summarize the utility index reported at different time point or stratified by modified Rankin Scale (mRS) levels. To provide evidence for economic evaluations.

METHODS: We searched PubMed, Web of Science, ScienceDirect, Embase and The Cochrane Library for studies measuring utilities in IS up to February 2022. Quality assessment was performed using criteria recommended by National Institute of Health and Care Excellence guideline. Utilities elicited by 3-level EuroQol-5 Dimension were pooled based on different valuation time point and mRS levels.

RESULTS: A total of 39 studies (22 observational studies and 17 randomized controlled studies) comprising 30,853 participants were included. Utilities reported during the acute phase ranged from -0.11 to 0.67 and the pooled estimate was 0.42 (95%CI: 0.13 to 0.71). Utilities measured at 3 months poststroke ranged from 0.34 to 0.71 and the pooled value increased to be 0.55 (95%CI: 0.43 to 0.68). When measured at 6 months poststroke, utilities ranged from 0.34 to 0.82 and the synthesized utility increased to be 0.65 (95%CI: 0.52 to 0.78). The pooled utilities were 0.60 (95% CI: 0.43 to 0.78) and 0.67(95%CI: 0.60 to 0.74) for 12 months poststroke and 24 months poststroke, respectively. It showed that the utility reached a relatively stable level after 6 months poststroke where no minimal important difference was found. As for the utility stratified by mRS levels, the synthesized estimates ranged from 0.91(95%CI: 0.85 to 0.97) to -0.04 (95%CI: -0.12 to 0.11) for mRS=1 to mRS=5.

CONCLUSIONS: Our findings suggest that the utility in IS reached a stable level after 6 months poststroke and provide synthesized utilities by mRS levels, which facilitates economic evaluations in utility retrieval and selection.