[P1.137] Factors Influencing Self-Perception of Recovery from Stroke in Comparison to Objective Assessments
T. Keta Hodgson,1Randy Sanoff,1Gillian Devereux,1Star Feudi,1Samantha Cherin,1Fiona Chatfield,1Robin Conwit,2Scott Hamilton,3Nerses Sanossian,1Sidney Starkman,1Jeffrey Saver,1the FAST-MAG Investigators and Coordinators
1Los Angeles, CA, USA, 2Lutherville, MD, USA, 3San Francisco, CA, USA
OBJECTIVE To determine factors accounting for an observed mismatch between stroke patients' objective and subjective assessments.
BACKGROUND: Often there are discrepancies between a stroke survivor's perception of recovery and results of objective scales used in clinical research, e.g., the modified Rankin scale (mRS). This discrepancy can be influenced by cultural factors and lifestyle. We sought to describe the variability and factors impacting self-reported recovery in a group of stroke patients participating in a clinical trial who have been evaluated by a study nurse and deemed to be free of substantial disability.
DESIGN/METHODS: Field Administration of Stroke Therapy-Magnesium (FAST-MAG) is a phase 3 trial evaluating the effectiveness and safety of prehospital-initiated magnesium sulfate vs. placebo in improving long-term functional outcome of patients with stroke <2 hours from onset. Selected subjects had a Mini-Mental State Exam score >16 and 90-day mRS of 0, 1 or 2, indicating minimal disability. Self-judgment of degree of recovery was assessed with the Global Recovery Scale (GRS), a 0-100 visual analog scale within the Stroke Impact Scale.
RESULTS: 799 subjects meeting criteria were age 67 [SD13] years, 38% women, 22% Hispanic ethnicity, 79% White race, 75% hypertensive and 18% diabetic at enrollment. The GSR median score was 90 [IQR 75-100]. (Contrastingly, 469 patients with mRS 3-5, had GRS median 50 [IQR 30-65]). GRS scores varied by mRS rank: mRS 0:GRS 96; mRS 1:GRS 83; mRS 2:GRS 67. There was a weak correlation between older age and higher GRS (R= 0.097, p<0.001). Among minimally disabled patients, less global recovery was reported by individuals of Hispanic ethnicity [77 vs 84, p<0.001] and men [81 vs 85, p=0.007].
CONCLUSIONS: Among individuals with minimum post-stroke disability, patient perception of degree of global recovery is strongly influenced by degree of minor residual symptoms and minimum disability. For similar disability levels, lesser degree of recovery is perceived by individuals who are younger, are male, and are of Hispanic ethnicity.
Study Supported by: NIH/NINDS
Category - Cerebrovascular Disease and Interventional Neurology: Stroke and Systemic Vascular Disease
Monday, April 28, 2014 3:00 PM
P1: Poster Session I: Cerebrovascular Disease and Interventional Neurology: Rehabilitation and Recovery (3:00 PM-6:30 PM)