[Impact of rural or urban areas on disability after a stroke]. / Estudio del impacto del medio rural o urbano sobre la discapacidad residual tras un ictus.

OBJECTIVES: To assess the residual disability in a sample of patients after suffering a first episode of a stroke and to compare the disability of those patients who live in rural areas with those living in urban areas. METHODOLOGY: An observational, longitudinal study of a cohort of 89 patients from a Neurology Unit, affected by cerebrovascular accident. The following factors were assessed: sociodemographic and environmental factors, co-morbidity, functional status, disability, depression and anxiety, and quality of life. The different clinical and demographic variables were compared after admission to the unit, at hospital discharge, and 3 months afterwards. Regression analyses were also carried out in order to study the association between the clinical and sociodemographic factors, and post-stroke disability. RESULTS: Compared to their previous clinical state, after suffering a stroke patients showed a higher rate of co-morbidity (P<.0001), disability (P<.0001), depression (P=.002), and a poorer quality of life (P=.013). The difference between patients coming from rural and urban areas was not statistically significant in terms of disability, quality of life, anxiety, depression, or co-morbidity. CONCLUSIONS: The level of disability, depression and co-morbidity that patients showed after suffering a stroke was similar to the results obtained in other studies. As a novel feature, there were no differences between patients living in rural areas after suffering a stroke and those living in urban areas, as regards disability, depression, or co-morbidity.

Estudio del impacto del medio rural o urbano sobre la discapacidad residual tras un ictus / Impact of rural or urban areas on disability after a stroke

Objetivos: Evaluar la discapacidad residual en una muestra de pacientes tras un primer episodio de ictus y comparar dicha discapacidad entre los pacientes que viven en un medio rural y en un medio urbano. Metodología Estudio observacional, longitudinal, de una cohorte de 89 pacientes afectados por enfermedad cerebrovascular ingresados en el Servicio de Neurología. Se evaluaron factores sociodemográficos y medioambientales, comorbilidad, estado funcional, discapacidad, depresión y ansiedad y calidad de vida. Se realizaron comparaciones de las diferentes variables clínicas y sociodemográficas al ingreso, al alta del centro hospitalario y a los 3 meses, así como un análisis de regresión para estudiar la asociación entre factores clínicos y sociodemográficos con discapacidad postictus. Resultados Comparados con su situación clínica previa, los pacientes tras sufrir un ictus presentaron mayor frecuencia de comorbilidad (p < 0,0001), discapacidad (p < 0,0001), depresión (p = 0,002) y menor calidad de vida (p = 0,013). No hubo diferencias estadísticamente significativas cuando se compararon los pacientes procedentes de un área rural con los de un área urbana en términos de discapacidad, calidad de vida, ansiedad, depresión y comorbilidad. Conclusiones Los grados de discapacidad, depresión y comorbilidad que presentaron los pacientes tras un episodio de ictus fueron similares a los obtenidos en otros estudios. Como aspecto novedoso, no existieron diferencias en cuanto a discapacidad, depresión y comorbilidad al comparar los pacientes del medio rural y urbano tras sufrir un ictus (AU)

OBJECTIVES: To assess the residual disability in a sample of patients after suffering a first episode of a stroke and to compare the disability of those patients who live in rural areas with those living in urban areas. METHODOLOGY: An observational, longitudinal study of a cohort of 89 patients from a Neurology Unit, affected by cerebrovascular accident. The following factors were assessed: sociodemographic and environmental factors, co-morbidity, functional status, disability, depression and anxiety, and quality of life. The different clinical and demographic variables were compared after admission to the unit, at hospital discharge, and 3 months afterwards. Regression analyses were also carried out in order to study the association between the clinical and sociodemographic factors, and post-stroke disability. RESULTS: Compared to their previous clinical state, after suffering a stroke patients showed a higher rate of co-morbidity (P<.0001), disability (P<.0001), depression (P=.002), and a poorer quality of life (P=.013). The difference between patients coming from rural and urban areas was not statistically significant in terms of disability, quality of life, anxiety, depression, or co-morbidity. CONCLUSIONS: The level of disability, depression and co-morbidity that patients showed after suffering a stroke was similar to the results obtained in other studies. As a novel feature, there were no differences between patients living in rural areas after suffering a stroke and those living in urban areas, as regards disability, depression, or co-morbidity (AU)