Predicting the Courses of Participation in Younger Patients with Stroke Following Discharge

Research Objectives: To explore the courses of participation among younger patients ( < 65 years) with stroke in Taiwan following their discharge and to identify the predictors of these courses.

Design: Prospective, longitudinal cohort study with repeated-measures.

Setting: Acute care settings in Taiwan.

Participants: A total of 570 patients with stroke (mean age: 52.6±8.3 years; 228 (40%) were female; and 69% had an ischemic stroke) were enrolled in this study and completed baseline assessment at hospital discharge; among whom 537, 505, and 458 patients completed 3-, 6-, and 12-month follow-up assessments, respectively.

Interventions: None.

Main Outcome Measures: The primary outcome measure was the Participation Measure–3 Domains, 4 Dimensions (PM-3D4D). Sociodemographic and stroke-related variables were derived using standardized instruments and questionnaires. Mixed models were used to derive the trends of each participation domain and to identify predictors.

Results: A positive trend was observed in PM-3D4D score changes from discharge to 1-year follow-up (particularly in the social and community subscales, p< 0.05); however, the improvement was mild and mainly occurred in the first 3 months. Sociodemographic factors, such as income and education levels, and stroke-related variables, such as stroke severity, comorbidity, and physical function, significantly predicted changes in PM-3D4D scores over time (p < 0.05). Physical function demonstrated the strongest prediction ability for all participation domains and dimensions.

Conclusions: Improvement in participation over time among younger patients with stroke was predicted by multiple sociodemographic and stroke-related variables, with physical function being the strongest predictor. These findings may assist clinicians in identifying patients at risk of unfavorable long-term participation outcomes.

Author(s) Disclosures: None of the authors have conflicts of interest.