The recovery paradox: analysis of psychosocial functioning and quality of life in patients with ischemic stroke after thrombectomy for thrombotic occlusion

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Background. Ischemic stroke remains one of the leading causes of mortality and disability despite significant advances in treatment, particularly the introduction of mechanical thrombectomy. However, following successful reperfusion, clinical attention is primarily focused on neurological deficits, while psychosocial consequences and patients’ quality of life often remain underestimated. This highlights the relevance of studying psychosocial functioning as a key component of comprehensive recovery after stroke. Purpose – to determine the indicators of psychosocial functioning and quality of life in patients who underwent thrombectomy for thrombotic occlusion. Materials and methods. A prospective clinical study of 129 patients was conducted in 2022–2025 at the Center of Roentgen-Endovascular Neurosurgery of the Kyiv City Clinical Hospital No. 1 and the Department of Roentgen-Endovascular Surgery of the State Institution «Main Medical Clinical Center of the Ministry of Internal Affairs of Ukraine» (Kyiv). The average age of the patients was 68.4±11.4 years. The assessment was performed on the 30–35th day after the surgical intervention. Clinical-psychopathological, psychodiagnostic (Scale for Comprehensive Assessment of the Degree of Psychosocial Maladjustment in Various Spheres by R.I. Isakov, Quality of Life Scale by J.E. Mezzich adapted by N.O. Maruta), and statistical methods were applied. Results. Signs of psychosocial maladjustment were detected in 93.8% of the patients. The most significant impairments were recorded in the macrosocial sphere (42.6% of patients with severe maladjustment), which is associated with the loss of ability to work. In the microsocial sphere, the formation of the phenomenon of family overprotection and «learned helplessness» was noted. The integral quality of life score was 49.4±8.5 points (a moderately decreased level). A significant decrease was found in the spheres of professional activity (2.1±0.9) and psychological well-being (4.3±1.6) against the background of relatively preserved ability for selfcare (5.8±1.3) and high socio-emotional support (7.6±1.1). Conclusions. The physical and neurological recovery of a patient after mechanical thrombectomy is not identical to their psychosocial recovery. The clinical picture of such patients is characterized by a pronounced dissonance between preserved physical functioning and a profound crisis of macrosocial integration against the background of emotional distress. This determines the need for an early multidisciplinary approach to rehabilitation with the involvement of mental health professionals.

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