Neurological outcome and health-related quality of life among Malaysian children with stroke

Aim: Describe the neurological and functional outcomes, and health-related quality of life (HRQL) of Malaysian children with stroke; and explore factors associated with poor outcomes and lower HRQL. Method: Cross-sectional study of Malaysian stroke children who were followed-up for at least 2 years. Paediatric Stroke Outcome Measure (PSOM) and modified Rankin scale (mRS) were utilised to assess neurological and functional outcomes. HRQL was assessed using PedsQL (Paediatric Quality of Life inventory) 4.0. Multiple regression analysis was used to determine factors associated with poor PSOM, poor mRS, and lower HRQL. Results: Seventy-six children were recruited. Majority have good mRS (72.4 %) and good PSOM (75 %). PedsQL total, physical health summary and psychosocial health summary mean scores were 74.2(SD 21.57), 74.2(SD 28.16) and 76.13(SD 18.66) respectively, which were significantly lower compared with healthy Malaysian children (p <= 0.001). Learning disability post-stroke was associated with poor PSOM and poor mRS; while cardiac surgery was associated with poor mRS. Learning disability post-stroke was associated with lower total, physical health summary and psychosocial health summary PedsQL scores. Poor mRS was associated with lower total PedsQL scores while poor PSOM was associated with lower total and physical health summary PedsQL. Conclusion: Although majority of Malaysian children with stroke had good long-term neurological and functional outcomes, they had lower HRQL compared to healthy Malaysian children. Optimizing care for cardiac surgery to reduce the risk of perioperative stroke may lead to improved neurological outcome. There is a need to address the issues of learning disability post-stroke and poor neurological outcome to reduce their impact on HRQL.