Stroke-related parameters affecting the deterioration of oral health-related quality of life as measured by OHIP-14 three months after ischemic stroke

缺血性卒中后三个月,影响口腔健康相关生活质量(以OHIP-14评估)恶化的卒中相关参数

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Abstract

OBJECTIVES: Oral health-related quality of life (OHRQoL) depends not only on oral diseases and hygiene but also on various psychosocial and medical conditions, including stroke and its complications. This study aimed to identify parameters influencing deterioration of OHRQoL, measured with the Oral Health Impact Profile-14 (OHIP-14) questionnaire from the acute stroke onset to 3 months later. METHODS: We prospectively analyzed data from 392 participants in the iBioStroke project, all of whom completed OHIP-14 questionnaire during the acute phase of ischemic stroke and again 3 months after its onset. We considered 37 demographic, clinical, radiological, and biochemical parameters available during the acute phase of stroke, as well as cognitive and mood disturbances that occurred during the follow-up period between two groups: Group I, consisting of patients whose OHIP-14 scores remained stable or decreased (OHRQoL stable or improved) by at least 1 point between the acute phase of stroke and 3 months after its onset, and Group II, comprising those whose OHIP-14 scores increased (OHRQoL deteriorated) by at least 1 point in the total score over the same period of time. RESULTS: Univariate regression testing revealed that patients in Group II (n = 189), compared to Group I (n = 203), more frequently presented with consistent anxiety (OR = 2.67, 95%CI: 1.49-4.87, p = 0.001) and consistent depression (OR = 2.10, 95%CI: 1.07-4.23, p = 0.033). Additionally, they were more likely to experience deterioration of pre-existing anxiety (OR = 2.88, 95%CI: 1.64-5.14, p < 0.001) and depression (OR = 2.42, 95%CI: 1.45-4.11, p < 0.001). Patients who experienced deterioration in their OHRQoL exhibited higher platelet count (mean values: 235.5 ± 78.7 vs. 218.2 ± 62.8 × 10(3)/uL, OR = 1.00, 95%CI: 1.00-1.01, p = 0.019) compared to those who did not. Logistic regression analysis indicated that deterioration of anxiety (OR = 2.20, 95%CI: 1.20-4.09, p = 0.011), consistent anxiety (OR = 2.16, 95%CI: 1.15-4.11, p = 0.018), and higher platelet count (OR = 1.00, 95%CI: 1.00-1.01, p = 0.05) were independent risk factors for deterioration of OHRQoL as measured with the OHIP-14 questionnaire between the acute phase of stroke and 3 months after its onset. CONCLUSIONS: Our study reveals that over 48% of ischemic stroke patients experience a decline in their OHRQoL. Our findings also highlight the necessity for vigilant monitoring of post-stroke anxiety both during the acute phase of stroke and throughout follow-up, as it impacts the risk of deterioration in OHRQoL. This issue holds significance because post-stroke anxiety is treatable with psychological and pharmacological interventions.

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