Calidad de vida en pacientes con ictus isquémico / Quality of life in patients with ischaemic stroke

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[Cognitive deterioration following cerebral infarction: frequency and determining factors]. / Deterioro cognitivo después de un infarto cerebral: frecuencia y factores determinantes.

INTRODUCTION: Stroke is often associated with cognitive deterioration (CD) in varying degrees, and the risk factors associated to CD after a stroke vary from one study to another. AIMS: To determine the frequency of CD following cerebral infarction and to identify the factors that account for its presence. PATIENTS AND METHODS: A descriptive study was performed involving 126 stroke survivors who were hospitalised for rehabilitation. Patients were classified as having CD if they had scores below the cut-off point in one of the cognitive tests that were applied, i.e. the Folstein Minimental Test (< 24) or the Command-Condition Clock Test (< 7). The explanatory variables were: demographic variables (age, sex and years of schooling), comorbidity (arterial hypertension, diabetes mellitus and intelligence quotient), noxious habits (smoking and drinking), variables related to the lesion (extension, hemisphere and location), and others related to the consequences of the stroke (neurological status and depression). Bivariate and logistic regression analyses were performed to determine the role of these variables in CD. RESULTS: CD was observed in 51.6% of the patients. In the bivariate analysis, the extension of the infarction, age, years of schooling, degree of neurological compromise and depression were associated with the presence of CD. The logistic regression model showed that the factors explaining CD were severe neurological compromise (OR = 22.9; CI 95% = 4.2-125.2), having major depression (OR = 2.9; CI 95% = 1.14-7.8) and older age (OR = 0.94; CI 95% = 0.89-0.98). CONCLUSIONS: A little more than half of all stroke survivors, who are undergoing rehabilitation in hospital, have CD. The factors with the greatest explanatory power to account for CI were neurological status, depression and age.

Deterioro cognitivo después de un infarto cerebral: frecuencia y factores determinantes / Cognitive deterioration following cerebral infarction: frequency and determining factors

El ictus se asocia con frecuencia a deterioro cognitivo (DC) de diverso grado; los factores de riesgoasociados al DC después de un ictus varían entre estudios. Objetivos. Determinar la frecuencia de DC después de un infarto cerebral e identificar los factores que explican su presencia. Pacientes y métodos. Estudio descriptivo de 126 supervivientes aun ictus, hospitalizados para rehabilitación. Se clasificaron como DC aquéllos con puntuaciones por debajo del punto de corte en una de las pruebas cognitivas aplicadas: test minimental de Folstein (< 24) o prueba del reloj a la orden (< 7). Comovariables explicativas: variables demográficas (edad, sexo y años de estudio cursados), sobre comorbilidad (hipertensión arterial, diabetes mellitus y cardiopatía isquémica), hábitos tóxicos (tabaquismo y alcohol), relacionadas con la lesión (extensión,hemisferio y localización) y relacionadas con las consecuencias del ictus (estado neurológico y depresión). Se realizó un análisis bivariado y de regresión logística para determinar el papel de estas variables en el DC. Resultados. El 51,6% de lospacientes presentó DC. En el análisis bivariado, la extensión del infarto, la edad, los años de estudio, el grado de afectación neurológica y la depresión se asociaron a la presencia de DC. El modelo de regresión logística mostró que los factores que explicanel DC fueron: una afectación neurológica grave (OR = 22,9; IC 95%: = 4,2-125,2), tener una depresión mayor (OR = 2,9; IC 95% = 1,14-7,8) y una mayor edad (OR = 0,94; IC 95% = 0,89-0,98). Conclusiones. Poco más de la mitad de los supervivientes a un ictus que se hospitalizan para rehabilitación presentan DC. Los factores que explican con mayor fuerza el DC fueron el estado neurológico, la depresión y la edad

Stroke is often associated with cognitive deterioration (CD) in varying degrees, and the risk factorsassociated to CD after a stroke vary from one study to another. Aims. To determine the frequency of CD following cerebral infarction and to identify the factors that account for its presence. Patients and methods. A descriptive study was performedinvolving 126 stroke survivors who were hospitalised for rehabilitation. Patients were classified as having CD if they had scores below the cut-off point in one of the cognitive tests that were applied, i.e. the Folstein Minimental Test (< 24) or the Command-Condition Clock Test (< 7). The explanatory variables were: demographic variables (age, sex and years ofschooling), comorbidity (arterial hypertension, diabetes mellitus and intelligence quotient), noxious habits (smoking and drinking), variables related to the lesion (extension, hemisphere and location), and others related to the consequences of the stroke (neurological status and depression). Bivariate and logistic regression analyses were performed to determine the role ofthese variables in CD. Results. CD was observed in 51.6% of the patients. In the bivariate analysis, the extension of the infarction, age, years of schooling, degree of neurological compromise and depression were associated with the presence ofCD. The logistic regression model showed that the factors explaining CD were severe neurological compromise (OR = 22.9; CI 95% = 4.2-125.2), having major depression (OR = 2.9; CI 95% = 1.14-7.8) and older age (OR = 0.94; CI 95% = 0.89- 0.98). Conclusions. A little more than half of all stroke survivors, who are undergoing rehabilitation in hospital, have CD. Thefactors with the greatest explanatory power to account for CI were neurological status, depression and age