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Mixture modelling analysis of one-month disability after stroke: stroke outcomes study (SOS1)

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Abstract

Purpose

Understanding the heterogeneity in disability after stroke is important to guide treatment and rehabilitation planning. We explored mixture modelling analysis to identify subgroups of stroke disability and factors associated with disability subgroups.

Method

Analyses were performed using secondary data from a cohort of 448 stroke patients who participated in a 2-year study of stroke outcomes. Mixture modelling approach was used to determine subgroups of early disability following stroke based on the Barthel Index, General Health Questionnaire (GHQ-28), Frenchay Activities Index and the Nottingham Extended Activities of Daily Living Scale.

Results

Five distinct disability groups were identified. Nineteen (4.2 %) patients were classified as having very severe disability, 58 (12.9 %) severe disability, 133 (29.7 %) moderate disability, 198 (44.2 %) mild disability and 40 (8.9 %) a mood disorder. Compared to the mild group, patients in the “very severe” group were more likely to be elderly and to have had a previous stroke, and less likely to live alone and had a greater risk of mortality 2 years after stroke. Patients in the mood disorder group showed greater dependency in activities of daily living were younger compared to the other groups and had a greater risk of having mood symptoms 2 years after stroke.

Conclusion

Mixture modelling of 1-month disability after stroke using a broad range of outcome measures has identified clinically meaningful groups relating to long-term outcomes.

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Abbreviations

SOS:

Stroke outcomes study

BI:

Barthel Index

GHQ:

General Health Questionnaire

PSE:

Post-stroke examination

NEADL:

Nottingham Extended Activities of Daily Living

ADL:

Activities of daily living

HRQoL:

Health-related quality of life

LPA:

Latent profile analysis

FAI:

Frenchay Activities Index

BIC:

Bayesian information criteria

LMR:

Lo-Mendell-Rubin likelihood ratio test

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Author information

Authors and Affiliations

  1. LIGHT, Division of Biostatistics, University of Leeds, Leeds, UK

    Theresa Munyombwe

  2. Leeds Institute of Health Sciences, University of Leeds, Leeds, UK

    Kate M. Hill & Robert M. West

  3. Department of Health Sciences, University of York, York, UK

    Peter Knapp

  4. Centre for Epidemiology & Biostatistics, University of Leeds, Worsely Building, Leeds, LS2 9JT, UK

    Theresa Munyombwe

Authors
  1. Theresa Munyombwe
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  2. Kate M. Hill
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  4. Robert M. West
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Correspondence to Theresa Munyombwe.

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Munyombwe, T., Hill, K.M., Knapp, P. et al. Mixture modelling analysis of one-month disability after stroke: stroke outcomes study (SOS1). Qual Life Res 23, 2267–2275 (2014). https://doi.org/10.1007/s11136-014-0681-0

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