Évaluer la QDV en post-AVC et étudier ses rapports avec le degré du handicap physique et les troubles émotionnels.

Nous avons mené une étude transversale, ayant inclus 147 patients vus en consultation externe de neurologie au centre hospitalo-universitaire de Sfax, pour un suivi après AVC dont la survenue remontait au maximum à un an. Nous avons utilisé les échelles SF-36, HAD et le Rankin modifié.

La QDV était altérée dans 68 % des cas. La prévalence de l’anxiété était de 55,1 % et celle de la dépression de 67,3 %. L’altération de la composante mentale était significativement corrélée à la présence d’anxiété (p=0,008) et de dépression (p<<0,05). Le degré du handicap sévère avait une influence négative significative sur l’ensemble des domaines de la QDV excepté celui de la vie et relations avec les autres.

L’altération de la QDV est fréquente en post-AVC. La survenue d’anxiété et de dépression et le degré du handicap physique semblent en être des facteurs prédictifs. Dès lors, une attention particulière doit être portée à de tels patients.

The physical and/or psycho-cognitive changes after stroke may lead to a decline in the quality of life (QOL) of patients. The aims of our study were to evaluate the QOL of stroke survivors and to investigate its relationships with the physical disability degree and the emotional disorders (anxiety and depression).

We conducted a cross-sectional study, which included 147 patients, followed for stroke that had occurred over the past year, in the outpatient neurology department at the university hospital Habib Bourguiba of Sfax (Tunisia). For each patient, we collected socio-demographic characteristics and clinical and therapeutic data. The quality of life of our patients was assessed using the SF-36 scale. The HAD scale was used to screen for anxiety and depression, whereas the modified Rankin scale was used to measure the degree of disability.

The average age of our patients was 60.58 years. The overall mean score of the SF-36 ranged from 20.81 to 89.81 with an average of 55.27. Impaired QOL was found in 68% of patients. The study of the dimensional average scores revealed that only two dimensions of the SF-36 were not altered: physical pain and life and relationship with others. The physical component was slightly more altered than the mental component (41.4 and 42.9 respectively). A minimal disability was found in 32% of patients, while a moderate and severe disability was found in 19% and 21.1% of patients. Anxiety was detected in 55.1% of patients and depression in 67.3% of them. Impaired mental component QOL was significantly correlated with the presence of anxiety (P=0.008) and depression (P<<0.05). The severe degree of disability had a significant negative impact on all areas of QOL except that of life and relationships with others.

It appears from our study that among the important effects of stroke is the constant deterioration of QOL in its various dimensions. The occurrence of emotional disturbances such as anxiety and depression and the degree of physical disability seem to be predictors of QOL impairment. Therefore, special attention should be given to such patients at higher risk of decline in their QOL.