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.