Post-stroke Pathway: Analysis and Link With One Year Sequelae in a French Cohort of Stroke Patients

Study Overview
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Brief Summary
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The link between post-stroke pathways and patient sequelae have not yet been clearly defined. The main purpose is to identify the post-stroke life pathways components associated with sequalae at 3 months and 1 year after the acute stroke episode.

Detailed Description
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Stroke is a serious health event, involving the entire health care system and generating considerable socioeconomic weight for society. Knowledge of the components, the diversity and the scalability of post-stroke life pathways is currently not sufficient. Moreover the link between post-stroke pathways and patient sequelae have not yet been clearly defined. The main purpose is to identify the post-stroke life pathways components associated with sequalae at 3 months and 1 year after the acute stroke episode. The secondary objectives are: 1) To define a typology of the life pathways of stroke patients, , 2) To analyze the social and geographical inequalities in the management of stroke, 4) To estimate the cost of the pathway elements of stroke management; 5) Measure the sequelae of stroke patients at three months and one year after the acute episode. The design is a prospective multicenter cohort study with a follow up to 1 year after the acute episode, managed in several hospitals in the Aquitaine region (France).

Official Title
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Post-stroke Pathway: Analysis and Link With One Year Sequelae in a French Cohort of Stroke Patients

Conditions
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Stroke, Stroke Sequelae

Intervention / Treatment
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* Other: Telephone Interview


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patient being over 18 years of age living in metropolitan France; Patient with recent stroke (not before 2019) whose diagnosis confirmed by a neuro-vascular physician; Patient managed for stroke in one of the 13 participating hospitals of the Aquitaine region; Patient giving consent to participate to PAPASéPA; Patient to be alive at the end of the acute management hospital stay Exclusion Criteria: Patient refuse to participate to PAPASéPA Patient died during the initial stay

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Other: Telephone Interview|Telephone Interview|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Modified Rankin Scale (mRS) Score | Activity limitations post-stroke measure. Minimum score : 0 No symptoms at all  Maximum score : 6 Dead | 3 months | 
| Modified Rankin Scale (mRS) Score | Activity limitations post-stroke measure Minimum score : 0 no symptom Maximum score : 6 death | 1 year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Telephone Interview for Cognitive Status Modified (TICS) Score | Cognitive disorders post-stroke measure Score from 0 to 43 | 3 months | 
| Telephone Interview for Cognitive Status Modified (TICS) Score | Cognitive disorders post-stroke measure Score from 0 to 43 | 1 year | 
| Hospital anxiety and depression scale (HADS) Score | Depression and anxiety disorders post-stroke measure Scores ranged from 0 (minimum) to 21 (maximum) for anxiety and 0 (minimum) to 21 (maximum) for depression. Total score from 0 to 42 | 3 months | 
| Hospital anxiety and depression scale (HADS) Score | Depression and anxiety disorders post-stroke measure Scores ranged from 0 (minimum) to 21 (maximum) for anxiety and 0 (minimum) to 21 (maximum) for depression. Total score from 0 to 42 | 1 year | 
| Fatigue Severity Scale (FSS) Score | The Fatigue Severity Scale (FSS) is designed to differentiate fatigue from clinical depression, since both share some of the same symptoms. Essentially, the FSS consists of answering a short questionaire that requires the subject to rate his or her own level of fatigue. The subject is asked to read each statem ent and circle a number from 1 to 7, depending on how appropriate they felt the statement applied to them over the preceding week. A low value indicates that the statement is not very appropriate whereas a high value indicates agreement. The scoring is done by calculating the average response to the questions (adding up all the answers and dividing by nine). People with depression alone score about 4.5. People with fatigue average about 6.5. | 3 months | 
| Fatigue Severity Scale (FSS) Score | The Fatigue Severity Scale (FSS) is designed to differentiate fatigue from clinical depression, since both share some of the same symptoms. Essentially, the FSS consists of answering a short questionaire that requires the subject to rate his or her own level of fatigue. The subject is asked to read each statem ent and circle a number from 1 to 7, depending on how appropriate they felt the statement applied to them over the preceding week. A low value indicates that the statement is not very appropriate whereas a high value indicates agreement. The scoring is done by calculating the average response to the questions (adding up all the answers and dividing by nine). People with depression alone score about 4.5. People with fatigue average about 6.5. | 1 year | 
| Barthel Index (BI) Score | Functional outcome post-stroke measure The original 10-item form of the BI consists of 10 common ADL activities including: feeding, bathing, grooming, dressing, bowel control, bladder control, toileting, chair transfer, ambulation and stair climbing. Items are rated in terms of whether individuals can perform activities independently, with some assistance, or are dependent (scored as 10, 5 or 0). Items are weighted according to the level of nursing care required. Total score from 0 to 100 | 3 months | 
| Barthel Index (BI) Score | Functional outcome post-stroke measure The original 10-item form of the BI consists of 10 common ADL activities including: feeding, bathing, grooming, dressing, bowel control, bladder control, toileting, chair transfer, ambulation and stair climbing. Items are rated in terms of whether individuals can perform activities independently, with some assistance, or are dependent (scored as 10, 5 or 0). Items are weighted according to the level of nursing care required. Total score from 0 to 100 | 1 year | 
| Community Integration Questionnaire (CIQ-R) Score | Participation restrictions post-stroke measure Score from 0 to 35 | 3 months | 
| Community Integration Questionnaire (CIQ-R) Score | Participation restrictions post-stroke measure Score from 0 to 35 | 1 year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Stroke, Pathways, Sequelae, Health services research