Quality of life after paediatric ischaemic stroke

• Published in: Developmental medicine and child neurology 2017-01, Vol.59 (1), p.45-51
• Main Authors: Kornfeld, Salome, Studer, Martina, Winkelbeiner, Stephanie, Regényi, Mária, Boltshauser, Eugen, Steinlin, Maja, Mori, A Capone, Datta, A, Fluss, J, Hackenberg, A, Keller, E, Maier, O, Marcoz, J‐P, Poloni, C, Ramelli, G‐P, Schmid, R, Schmitt‐Mechelke, T
• Format: Article
• Language: English
• Subjects: Adolescent; Age Factors; Analysis of Variance; Brain Ischemia - complications; Child; Child, Preschool; Cognition Disorders - etiology; Female; Humans; Infant; Intelligence; Male; Neurologic Examination; Parents - psychology; Quality of Life - psychology; Retrospective Studies; Self Report; Sex Factors; Stroke - etiology; Stroke - psychology
• ISSN: 0012-1622; 1469-8749
• DOI: 10.1111/dmcn.13295

Aim Paediatric arterial ischaemic stroke can lead to reduced quality of life (QoL). It is important to identify predictors of QoL to support recovery. We examined long‐term QoL after arterial ischaemic stroke concerning different variables. Method Children registered in the Swiss Neuropediatric Stroke Registry and suffering from arterial ischaemic stroke between 2000 and 2008 were included. Two years post‐stroke, assessments included intelligence quotient tests for cognitive impairment and modified Rankin Scale (mRS) for neurological impairment; 5 years post‐stroke, the Kidscreen‐27 was used for QoL, DSM‐IV criteria screening was used for attention deficits, and the ABILHAND‐Kids was used for manual motor skills. Age at stroke, sex, socioeconomic status, lesion characteristics, neuropsychological and motor outcome, and mRS were correlated with QoL measures. Results Seventy children were examined (49 males, 21 females; mean age 7y 2wks). Age at stroke, sex, socioeconomic status, and lesion characteristics did not influence QoL; IQ below average and attention deficits partially influenced QoL. The highest predictive value for QoL was found for manual motor impairment (p=0.002) and mRS scores (p=0.013). Combined motor, cognitive, and attention impairment negatively affected QoL (p=0.001). Interpretation Neurological and cognitive impairments after paediatric arterial ischaemic stroke negatively influence QoL. Children with motor and neurological problems, as well as those with combined motor, cognitive, and attention problems, are at higher risk for low QoL. What this paper adds Quality of life (QoL) after paediatric arterial ischaemic stroke is not significantly reduced compared with healthy children. Neurological and cognitive deficits negatively influence QoL after paediatric stroke. Combined deficits predict particularly low QoL. Neurological impairment is an important predictor of lower long‐term QoL. Patients suffer most from social problems in their everyday life. This article is commented on by Lo on pages 7–8 of this issue.